Trauma-Informed Screening for Structural Drivers of Health

Screening for structural drivers or determinants of health (SDoH), as mandated by recent federal regulations, raises ethical questions about screening processes and tools. Early childhood adversity and trauma, which can influence a person's health throughout their lifespan and contribute to chronic disease and early death, can be identified through standardized screening for SDoH. However, screening without awareness of the potential interface between SDoH and trauma can retraumatize those administering or completing the screening process. This article suggests that implementation of a trauma-informed approach to SDoH screening is consistent with biomedical and public health ethics and contributes to efforts to keep clinical environments emotionally safe.