The Association of Social Determinants of Health Screening With Developmental and Social-Emotional Outcomes in Children Enrolled in Head Start

Introduction/Objectives: Social determinants of health (SDOH) have the potential to differentially impact child developmental outcomes. This study examined whether scores on the Environmental Screening Questionnaire (ESQ), a newly developed SDOH screening tool, were associated with scores on the Brigance and Ages & Stages Questionnaires-Social-Emotional (ASQ:SE-2) child development assessments. Methods: Brigance, ASQ:SE-2, and ESQ scores from children enrolled in a Head Start Program in Northeast Iowa were collected during the 2021 to 2022 and 2022 to 2023 school years. Associations between scores in each ESQ domain and Brigance and ASQ:SE-2 scores were assessed. Results: Education-Employment and Community concerns on the ESQ were associated with reduced Brigance scores ( r  = −.21, P  < .001; r  = −.17, P  = .001). Concerns related to Housing, Child and Family Health, and Community were associated with more concerning ASQ:SE-2 scores ( r  = .14, P  = .005; r  = .18, P  < .001; r  = 0.27, P  < .001). In multivariable models controlling for sex and ethnicity, Education-Employment concerns were significant predictors of lower Brigance scores, while Child and Family Health and Community concerns were significant predictors of ASQ:SE-2 scores. Conclusions: ESQ scores in certain SDOH domains correlate significantly with child developmental outcomes. The ESQ domains of Child and Family Health and Community appear to be particularly important for appropriate child socio-emotional development. Interventions should focus on addressing critical SDOH domains to promote child resilience and counteract the non-medical factors that can interfere with child developmental outcomes.