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      Cost of living crisis: a UK crisis with global implications – A call to action for paediatricians

      review-article
      1 , , 2
      BMJ Paediatrics Open
      BMJ Publishing Group
      Ethics, Epidemiology, Health services research

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          Abstract

          The UK’s ‘cost of living crisis’ (COLC) has thrown millions of families into poverty in 2022, delivering an intensifying economic shock that will likely eclipse the financial impact of the global coronavirus pandemic for children, families and communities alike. But what is the relevance for paediatricians? Written by doctors who spend considerable time confronting social problems from clinical, public health and advocacy perspectives, this article aims to untangle the COLC for those working in child health and seeks to stimulate a meaningful conversation about how we might reimagine paediatrics for life in the 21st century.

          Taking the current crisis as our point of departure, we argue that the UK’s COLC can be best understood as a ‘ crisis of inequality’, which has been created through social, economic and political processes that were not inevitable. The health impacts, then, are a matter of health equity and social justice. While the acuity of the crisis unfolding in the UK garners much attention, the implications are global with lessons for paediatricians everywhere. We propose that using a ‘social lens’ for understanding the true ‘causes of the causes’ of complex challenges such as COLC is essential for the 21st century paediatrician, as the consequences for child health is deep, wide-ranging and long-lasting. However, the current gap in knowledge, skills and infrastructure in this area leads to disempowerment in the profession.

          We end with this provocation: What, after all, does it mean to be a paediatrician in a time of economic crisis? We offer thoughts about how paediatrics might respond to social challenges, such as the COLC, acknowledging that organised and concerted action must be taken both inside and outside of health systems if we are to help bring about the changes that our patients and their surrounding communities urgently need.

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          The NHS long term plan

          Rightly ambitious, but can the NHS deliver?
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            Social prescribing

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              Screening for social determinants of health in clinical care: moving from the margins to the mainstream

              Background Screening for the social determinants of health in clinical practice is still widely debated. Methods A scoping review was used to (1) explore the various screening tools that are available to identify social risk, (2) examine the impact that screening for social determinants has on health and social outcomes, and (3) identify factors that promote the uptake of screening in routine clinical care. Results Over the last two decades, a growing number of screening tools have been developed to help frontline health workers ask about the social determinants of health in clinical care. In addition to clinical practice guidelines that recommend screening for specific areas of social risk (e.g., violence in pregnancy), there is also a growing body of evidence exploring the use of screening or case finding for identifying multiple domains of social risk (e.g., poverty, food insecurity, violence, unemployment, and housing problems). Conclusion There is increasing traction within the medical field for improving social history taking and integrating more formal screening for social determinants of health within clinical practice. There is also a growing number of high-quality evidence-based reviews that identify interventions that are effective in promoting health equity at the individual patient level, and at broader community and structural levels.
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                Author and article information

                Journal
                BMJ Paediatr Open
                BMJ Paediatr Open
                bmjpo
                bmjpo
                BMJ Paediatrics Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2399-9772
                2022
                22 November 2022
                : 6
                : 1
                : e001631
                Affiliations
                [1 ]departmentCentre for Public Policy Research (CPPR) , King's College London , London, UK
                [2 ]Evelina London Children’s Hospital , London, UK
                Author notes
                [Correspondence to ] Dr Guddi Singh; guddi.singh@ 123456nhs.net
                Author information
                http://orcid.org/0000-0003-3263-393X
                Article
                bmjpo-2022-001631
                10.1136/bmjpo-2022-001631
                9685256
                36645799
                569710ec-2db2-425e-b0d4-fd822664aacd
                © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 06 September 2022
                : 04 November 2022
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                ethics,epidemiology,health services research
                ethics, epidemiology, health services research

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