In late June, Public Agenda published a report on perspectives of low-income parents on pediatric screening for social determinants of health. A key conclusion suggests a substantial challenge.

One of the report’s conclusions is:

The low-income parents in our focus groups understood their children were affected by the social determinants of health for which some pediatricians are screening. But they did not immediately identify pediatricians as sources of help with social needs—perhaps because few of them indicated having experienced pediatric care that attempted to address those needs. Parents’ frustration at the prospect of disclosing sensitive information without getting help may stem in part from their not expecting pediatricians to be able to help with those issues.

Maybe some pediatricians actually can’t do very much about social determinants. But even if some can (or when they can), this lack of trust that anything good will come out of disclosing needs warrants some reflection.

It’s a chicken and egg problem. Patients may need to experience tangible benefits from disclosure. But they can’t benefit until they disclose.