[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Views 1,001
Citations 0
Research Letter
April 27, 2020

The Interwoven Nature of Medical and Social Complexity in US Children

Author Affiliations
  • 1Division of General Pediatrics, Boston Children’s Hospital, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
  • 2Family Voices of Minnesota, Stillwater
  • 3Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison
  • 4Department of Pediatrics, David Geffen School of Medicine at UCLA (University of California at Los Angeles) and Mattel Children’s Hospital, Los Angeles
  • 5Children’s Hospital Association, Lenexa, Kansas
  • 6Department of Emergency Medicine, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
  • 7Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, Maryland
JAMA Pediatr. 2020;174(9):891-893. doi:10.1001/jamapediatrics.2020.0280

Health is strongly influenced by both medical conditions and social determinants of health (SDH). The degree to which challenges in one affect the frequency or magnitude of challenges in the other is not fully understood. Children with medical complexity may be at especially high risk for related social complexity.1,2 If so, then children with medical complexity may be even more vulnerable than their underlying illness might suggest owing to enhanced risk for SDH challenges. A comprehensive medical-social approach to pediatric complex care may be warranted—one not currently seen in traditional health care practices. To better understand this potential need, we compared the prevalence and types of SDH challenges across children by level of medical complexity.

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words