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Social determinants of health screening and pediatric surgical outcomes

Nicole Chicoine1, Dwight Barry2, Hannah Cockrell1

  • 1Division of Pediatric General and Thoracic Surgery, Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA; Department of Surgery, University of Washington, Box 356410, 1959 NE Pacific St, Seattle, WA 98195, USA.

Journal of Pediatric Surgery
|February 5, 2026
PubMed

Insights

Children with positive social determinants of health (SDOH) screening responses had higher rates of serious adverse events (SAE) after surgery. Addressing SDOH needs can improve pediatric surgical care.

Area of Science:

  • Pediatric Surgery
  • Health Services Research
  • Social Determinants of Health

Background:

  • Prior research indicates socioeconomic disparities in pediatric surgical outcomes.
  • Existing studies use broad SDOH indices, but the impact of specific screening tool responses is unknown.

Purpose of the Study:

  • To investigate the association between individual social determinants of health (SDOH) screening tool responses and pediatric post-operative outcomes.
  • To determine if specific SDOH needs correlate with adverse surgical events in children.

Main Methods:

  • Retrospective analysis of 28,130 pediatric surgical patients (ages 0-21).
  • Bayesian logistic regression to analyze the relationship between a four-domain SDOH screening tool and 30-day mortality/SAE.
  • Included adjustment for ASA, case duration, and patient age.

Main Results:

  • The incidence of 30-day mortality and SAE were 0.1% and 10%, respectively.
  • Positive SDOH screens were associated with increased odds of 30-day mortality and SAE on univariable analysis.
  • Housing instability and financial strain were linked to increased risk of SAE, with continued association after multivariable adjustment.

Conclusions:

  • Pediatric surgical patients with positive SDOH screening responses face higher rates of serious adverse events (SAE).
  • Analyzing SDOH needs in relation to perioperative outcomes is crucial for optimizing surgical care delivery for all children.
Abstract

Keywords:
Pediatric surgerySocial Determinants of HealthSurgical outcomes

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