SDOH in Pediatric Dermatology: Improving Outcomes
Bridging the Health Literacy Gap: Strategies for Equitable Dermatological Care
A staggering 88% of US adults lack proficient health literacy, a critical factor influencing treatment adherence, emergency department utilization, health outcomes, and even mortality. Dr. Sarah Coates, speaking at the Society for Pediatric Dermatology Annual Meeting, emphasized that addressing this gap is paramount for delivering equitable care, notably in dermatology.
Simplifying dialog for Better Outcomes
Coates stressed the importance of clinicians simplifying their language, eschewing medical jargon, and employing practical tools to enhance patient understanding.This includes utilizing diagrams, plain-language handouts, and visual aids. Crucially, these materials must be accessible at appropriate reading levels and in various languages, with Spanish being a key consideration. Empowering patients to photograph vital visuals for later reference can further reinforce comprehension and adherence.
Tackling Barriers to Care in Pediatric Dermatology
In pediatric dermatology, tailoring treatment plans to patients’ real-life circumstances is essential. Cost remains a significant barrier, with many families struggling to afford even basic over-the-counter treatments like emollients, which are frequently enough not covered by Medicaid. Clinicians are encouraged to inquire about discount memberships (e.g., Sam’s Club, Costco) that can make treatments more affordable. Adjusting recommendations to align with patients’ living situations is also vital.
Coates proposed a “3 as” approach-awareness, assistance, and adjustment-to help clinicians identify social risks, connect families with necessary resources, and adapt care plans accordingly.Telemedicine offers a powerful solution to overcome geographic and transportation barriers. Furthermore, billing for time spent addressing social determinants of health is crucial to acknowledge the complexity of patient care. The implementation of patient navigators is also recommended to ensure follow-up and continuity of care for high-need patients.
Enhancing Medical Training for Health Equity
To foster a future healthcare workforce equipped to address health disparities, Coates highlighted the progress of a formal curriculum on Social Determinants of Health (SDOH) for dermatology residents. This complete program includes lectures, journal clubs, and the establishment of a health equity chief resident role. These initiatives aim to equip trainees with the skills to recognize social drivers of health and integrate this understanding into patient care plans. A cornerstone of this program is the integration of patient navigators to support continuity of care for medically and socially complex patients. Mentoring and sponsoring students and residents passionate about health equity are also critical for building a more equitable future in medicine.
“Some other changes that we’ve made in our program include creating a model called the health equity chief resident, which is a group of residents who are dedicated to this curriculum and also for building engagement with our community,” Coates stated. “Give them a title so that they can feel empowered to really invest in this work.”
By prioritizing clear communication, addressing socioeconomic barriers, and embedding health equity principles into medical training, the field of dermatology can move towards providing more accessible, effective, and equitable care for all patients.
References:
- Coates, S. Identifying and addressing social and structural drivers of health. Presented at: Society for Pediatric Dermatology Annual Meeting; July 23-26, 2025; Seattle, WA.
- Williams J, Amerson EH, Chang AY. How dermatologists can address the structural and social determinants of health-from awareness to action.Jama Dermatol. 2022;158(4):351-352. doi:10.1001/jamadermatol.2021.5925