A mother comes to the pediatric clinic for a health maintenance visit for her children: an 18-month-old daughter, a 2 1/2-year-old daughter, and 4-year-old son. The small family appears clean but the clothes appear well-worn. The mother appears nervous and apologizes about their appearance, explaining things have been tough since she lost her job and they were evicted from their apartment.


Pediatric healthcare visits are crucial for monitoring the well-being of children and addressing any health concerns. During these visits, healthcare providers have the opportunity to not only assess the physical health of the children but also identify any psychosocial factors that may impact their overall well-being. This case presents a mother and her three children visiting a pediatric clinic for a health maintenance visit. The mother’s explanation about their current difficulties highlights the importance of addressing social determinants of health in pediatric care.

Identifying the Social Determinants of Health:

The social determinants of health encompass the social, economic, and environmental factors that influence an individual’s health status. These factors can include education, income, employment, housing, and social support networks. In this case, the mother’s loss of her job and eviction from their apartment indicate several potential challenges in meeting basic needs and maintaining their overall well-being.

Impact on Child Health:

The social determinants of health can have a significant impact on the health and development of children. Economic instability and housing insecurity can disrupt families’ access to healthcare, proper nutrition, and a safe living environment. These disruptions may lead to increased stress levels, inadequate nutrition, and increased risk of communicable diseases, among other health concerns. Additionally, the mother’s nervousness during the clinic visit may reflect heightened stress levels, which can further affect the parent-child relationship and overall child development.

Approaching the Case:

In this case, the healthcare provider should adopt a holistic approach that considers both the physical and social aspects of the family’s health. By addressing the social determinants of health, healthcare providers can work towards mitigating the impact of these factors on the children’s overall well-being and quality of life.


During the health maintenance visit, the healthcare provider should conduct a thorough assessment of the children’s physical health, growth, and development. This may include measurements such as height, weight, head circumference, and developmental milestones. Additionally, the provider should inquire about the children’s nutrition, immunization status, and any specific health concerns or symptoms.

Addressing Basic Needs:

Given the mother’s explanation of their current difficulties, addressing the family’s immediate basic needs becomes a priority. Healthcare providers should collaborate with community organizations, social workers, or case managers to ensure that the family has access to adequate food, clothing, and shelter. Connecting the family with local resources or assistance programs can help alleviate some of the stressors they are experiencing and support their overall well-being.

Referrals and Resources:

Apart from immediate basic needs, healthcare providers should also refer the family to appropriate resources and programs that may assist them in accessing long-term support. These resources may include housing assistance programs, employment support services, childcare options, and healthcare coverage. Collaboration with community agencies can facilitate access to these resources and help the family navigate through the available support systems.

Psychosocial Support:

Addressing the psychosocial needs of the family is crucial for ensuring the well-being of both parents and children. Healthcare providers can offer a supportive and empathetic environment to encourage open communication with the parents. Additionally, referring parents to social support networks, mental health services, or counseling can provide them with the necessary tools to cope with their current situation and promote resilience.


Pediatric healthcare visits provide an opportunity to identify and address the social determinants of health that may impact children and their families. In this case, the mother’s loss of employment and housing eviction highlight the importance of addressing basic needs and providing support for the family. By adopting a holistic approach, healthcare providers can collaborate with community resources and organizations to address immediate needs and connect families with long-term resources. By doing so, healthcare providers can contribute to the overall well-being and resilience of children and families facing challenging circumstances.

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