Social Determinants of Health: What Every Clinician Should Know | Michelle Noel, MSW, LICSW

Why It Matters

Systematic SDOH screening links social barriers to clinical outcomes, enabling targeted interventions that improve pediatric health equity and reduce costly missed care.

Key Takeaways

• Seattle Children's screens social determinants using iPad questionnaire.
• Five domains: financial, food, transportation, housing, physical activity.
• Positive screens link to missed appointments and delayed cochlear implants.
• Autonomy respected: families can decline screening or follow‑up.
• Data drives partnerships, e.g., Unite Us, to connect resources.

Summary

The video features Michelle Noel, a social worker at Seattle Children’s Hospital, outlining the hospital’s Social Determinants of Health (SDOH) screening program. Since November 2021, the clinic has used iPad‑based questionnaires to assess families across five core domains—financial insecurity, food insecurity, transportation barriers, housing instability, and physical activity—while allowing participants to opt out at any point. Noel presents data showing concrete health impacts: families reporting transportation challenges miss follow‑up ear‑tube appointments, and those with housing insecurity experience delays in pediatric cochlear implant evaluations. The screening process repeats every four months for identified needs and annually otherwise, and positive responses trigger personalized outreach rather than generic referrals. She emphasizes the ethical balance between data collection and patient autonomy, noting that caregivers can decline both the screen and any subsequent assistance. Confidentiality concerns are addressed, especially for pediatric patients whose records may be accessed by multiple caregivers, ensuring that sensitive disclosures do not inadvertently worsen home safety. The program’s outcomes have spurred collaborations, such as a partnership with Unite Us in 2024, to translate screening data into actionable community resources. By systematically identifying and responding to SDOH, Seattle Children’s aims to reduce health inequities, improve appointment adherence, and enhance overall child development outcomes.

Original Description

Presentation: Social Determinants of Health: What Every Clinician Should Know

Michelle Noel, MSW, LICSW

Explore family-centered care through the lens of perinatal mental health and social determinants of health. Participants will define the "perfect mother myth", examine the father's perspective, and learn to integrate mental health screening into practice. Gain insights to support family autonomy, improve delivery of care, and foster holistic outcomes through clinical expertise.

https://www.seattlechildrens.org/clinics/childhood-communication-center/patient-family-resources/