Emergency departments (EDs) frequently serve as critical healthcare access points for populations in rural areas, where primary care services are often sparse or difficult to reach. This unique role positions EDs as not only venues for acute medical intervention but also as vital touchstones for addressing broader social determinants of health that impact pediatric patients and their families. A groundbreaking observational study from the University of Missouri School of Medicine explores this potential through a novel pilot program known as Tigers ConnectED, which integrates social needs screening and remote intervention into pediatric emergency care.
The Tigers ConnectED program targets families visiting the pediatric ED by identifying unmet essential needs that influence a child’s overall health and well-being beyond medical factors alone. Conducted over an eight-week period, the study engaged 95 families, nearly half of whom reported at least one pressing social or economic challenge. Food insecurity emerged as the most prevalent issue, underscoring the intersection of nutrition and pediatric health outcomes within vulnerable populations. The program’s design included proactive follow-up contacts offering referral information to community resources capable of addressing these challenges.
Remote connectivity emerged as a cornerstone of Tigers ConnectED’s approach, with three-quarters of families requesting assistance successfully contacted post-ED visit. Communication was predominantly facilitated via text messaging, reflecting a deliberate strategy to meet families “where they are” in terms of accessibility and convenience. This method also circumvented practical barriers commonly faced by rural caregivers, such as transportation difficulties or conflicting work schedules that complicate attending primary care or specialty appointments.
Dr. Mary Beth Bernardin, a pediatric emergency medicine specialist and lead author of the study, highlights the strategic importance of ED-based social needs interventions. She notes that for many rural families, the emergency department represents the most reliable or only consistent point of medical engagement. Therefore, embedding screening tools and resource linkage processes within the ED setting leverages this clinical encounter to extend support beyond immediate health crises, fostering enhanced health equity and stability.
The demographic breakdown revealed approximately 40% of participating families hailed from surrounding rural counties. Intriguingly, although rural families were statistically less likely to seek help, their reported social health challenges were often comparable with urban counterparts. This parity suggests systemic gaps in resource accessibility affect diverse populations, reinforcing the need for tailored outreach mechanisms that account for geographic and socioeconomic nuances.
The wider implications of these findings are profound. By extending clinical care into social domains through programs like Tigers ConnectED, healthcare systems can play a transformative role in mitigating adverse childhood experiences rooted in social determinants. By facilitating timely connections to food assistance programs, transportation services, employment support, and other critical interventions, pediatric emergency departments can help safeguard not only immediate health but also long-term child development trajectories.
This innovative pilot builds upon the foundations laid by the original Tigers Connect program, initiated in pediatric clinics in 2021 by MU Health Care. Together, these initiatives reflect a strategic shift in healthcare paradigms towards holistic family well-being, emphasizing that medical outcomes cannot be disentangled from social context. Such models represent a forward-thinking trajectory for addressing entrenched health disparities in Missouri and potentially across similar rural-urban interfaces nationwide.
The research team behind this study comprises a multidisciplinary group, including medical students, statisticians, clinicians, and research coordinators, underscoring the collaborative nature of addressing complex social issues within healthcare. The study, recently published in the journal Family & Community Health, is titled “Social Determinants of Health Screening and Remote Intervention for a Pediatric Emergency Department: Reaching Rural Families.” This publication emphasizes the methodological rigor underpinning the observational study and shares insights that may inform replication or adaptation in varied clinical settings.
Beyond its immediate findings, this study invites broader conversations regarding the integration of technology to overcome logistical barriers. The success of text message follow-ups reveals how digital health strategies can augment traditional care approaches. This is especially relevant in rural contexts where broadband access may be limited, and personal device usage is more prevalent, allowing for scalable, cost-effective, and patient-centered intervention frameworks.
Moreover, the program highlights the ethical imperative of healthcare providers to screen for social determinants of health systematically. Routine incorporation of such screening within emergency departments could normalize identifying non-medical yet critical factors affecting outcomes. This may in turn promote a more equitable healthcare system that proactively recognizes and addresses the layered realities faced by rural families in accessing care and support.
The Tigers ConnectED initiative exemplifies a pragmatic yet visionary approach to pediatric emergency medicine, where the intersection of clinical expertise, social science, and community engagement yields promising pathways for health justice. By meeting families where they are—both clinically and socially—healthcare providers can foster meaningful improvements in child health, family resilience, and community welfare. As Dr. Bernardin poignantly notes, such outreach efforts have the potential to enact “real difference in the health and stability of children and their communities,” heralding a new era of integrative pediatric care.
This pioneering research not only elucidates the unmet social needs prevalent among rural pediatric patients but also concretely demonstrates the efficacy of remote interventions initiated from an emergency setting. It represents a scalable blueprint for health systems aiming to bridge the healthcare divide and optimally support families navigating multiple, intersecting vulnerabilities. Ultimately, Tigers ConnectED stands as a testament to the possibilities when medicine embraces a broader, more inclusive vision of health.
Subject of Research: People
Article Title: Social Determinants of Health Screening and Remote Intervention for a Pediatric Emergency Department: Reaching Rural Families
News Publication Date: 18-Aug-2025
Web References: http://dx.doi.org/10.1097/FCH.0000000000000439
Keywords: Rural populations, Social inequality
