Valley Healthcare

Improving Care for At-Risk Families and Children:
The Critical Role of the “Medical Home” and Integrated Medicine

A presentation entitled “Social Environment and The Life Health Course Trajectory in Children” given during a recent Pediatric Grand Rounds at The Medical Center in Columbus stressed the critical importance of Medical Homes like VHcS that provide the types of integrated physical and mental (behavioral) health care that we offer to vulnerable children and families. By ensuring that ALL patient needs are addressed – above the neck as well as below – we can not only improve the quality of life, but actually lengthen the life span of vulnerable children.

Dr. Yasmin Tyler-Hill, Associate Professor of Clinical Pediatrics, Interim Chair of Pediatrics, and Director, Division of General Pediatrics and Clinical Medicine at Morehouse School of medicine spoke about “Social Determinants of Health” and the tremendous impact that the social and family environments play on the health trajectory of children across their lifespan.

Put simply: adverse conditions (such as poverty, lack of resources, and inequities in health care), and adverse childhood experiences (such as neglect, abuse, family dysfunction, parental mental illness, violence, and trauma) are risk factors that are proven to shorten the life span of children. Without the needed protective factors that can be put in place to counteract some of these risk factors, children who are exposed to these negative conditions are less healthy, have more chronic illnesses, and typically go on to develop diseases, disorders, and life styles that shorten life expectancy. As an example, compare the life expectancy (81.3 years) of children raised in Montgomery County, Maryland, a very affluent county with extremely low rates of poverty, child abuse, and neglect, to the life expectancy (66.8 years) of a child raised in an impoverished county in South Carolina with high rates of poverty, abuse, and neglect.

These “social determinants of health” include concrete issues such as financial stability, adequate food, housing, and transportation, access to quality healthcare, and effective education, as well as less tangible but very important factors such as the mental health of children and their caregivers, the presence or lack of healthy functioning of the family system, and the quality of parent-child relationships. Behavioral medicine at VHcS focuses on the treatment of these environmental, relational, and social factors that have direct impact on a patient’s physical well-being and life-long health.

By providing at-risk families with quality mental and behavioral health, social work and advocacy services, and treatment for the emotional and behavioral problems that arise in response to adverse childhood experiences, VHcS is helping to put those needed protective factors in place.

As Dr. Tyler-Hill pointed out in her presentation, one of the goals of integrated medicine and quality health care is “to determine where and when can we do something to address the social determinants of health and improve a child’s life health trajectory”. At VHcS, we can be proud that we offer a full array of services to do just that.