A study conducted in Detroit examined the relationship between adverse social determinants of health (SDOH) and the severity of COVID-19 in children under 18. Researchers evaluated 354 children with symptomatic SARS-CoV-2 infections from March 2021 to April 2022. Among the participants, 113 experienced severe illness, defined as respiratory or cardiac failure or death within four weeks of diagnosis. Caregivers completed a survey revealing high instances of food and housing insecurity, lack of support, unmet childcare needs, and transportation issues. The majority of caregivers were aged 30-44, had less than a college degree, and reported incomes below $50,000. The study found that severe COVID-19 was significantly associated with caregivers’ use of drugs or alcohol and experiences of social discrimination or lack of support. These factors were linked to an increased likelihood of severe disease, highlighting the impact of social conditions on health outcomes. The authors suggest that further research is needed to validate these findings and to create targeted interventions to address these issues in pediatric populations.