Social determinants of health (SDH) influence health and social outcomes in positive and negative ways. Understanding the impact of SDH on children with cerebral palsy (CP) is essential to improve health equity, optimize health outcomes, and support children with CP and their families to thrive in society. In this narrative review, we summarize the landscape of SDH impacting children with CP and their families worldwide. In high‐income countries, children from poorer neighbourhoods are more likely to have severe comorbidities, present with spastic bilateral CP, and report lower frequency of participation in community activities. In low‐ and middle‐income countries, socioeconomic disadvantage is associated with increased risk of malnutrition, living in poorer housing conditions, not having access to proper sanitation, and living below the poverty line. Low maternal education is associated with increased likelihood of the child with CP experiencing increased severity of gross motor and bimanual functioning challenges, and poorer academic performance. Lower parental education is also associated with reduced child autonomy. On the other hand, higher parental income is a protective factor, associated with greater diversity of participation in day‐to‐day activities. A better physical environment and better social support are associated with higher participation in daily activities. Clinicians, researchers, and the community should be aware of these key challenges and opportunities. Then adopt a range of approaches that target adverse SDH/social needs and foster positive SDH in the clinical setting.What this paper adds: Understanding how social determinants of health influence health and social outcomes is a critical step towards improving health equity and outcomes. Approaches are required that target the impact of adverse SDH on access to health care for children with cerebral palsy and that work towards ensuring equity of access for all.

Aim: To determine factors that influence non‐attendance at outpatient clinics by children with cerebral palsy (CP).Method: This was a retrospective cohort study of 1395 children with CP (59.6% male; born 2005 to 2017) identified from the New South Wales (NSW)/Australian Capital Territory CP Register, who had scheduled appointments at outpatient clinics at two NSW tertiary paediatric hospitals between 2012 and 2019. Associations between sociodemographic, clinical, and process‐of‐care factors and non‐attendance were examined using multivariate logistic regression with generalized estimating equations.Results: A total of 5773 (12%) of 50 121 scheduled outpatient days were not attended. Non‐attendance increased over time (average increase 5.6% per year, 95% confidence interval [CI]: 3.7–7.3). Older children aged 5 to 9 years (adjusted odds ratio [aOR] 1.11; 95% CI: 1.02–1.22) and 10 to 14 years (aOR 1.17; 95% CI: 1.03–1.34), socioeconomic disadvantage (aOR 1.29; 95% CI: 1.11–1.50), previous non‐attendance (aOR 1.38; 95% CI: 1.23–1.53), and recent rescheduled or cancelled appointments (aOR 1.08; 95% CI: 1.01–1.16) were associated with increased likelihood of non‐attendance.Interpretation: One in eight outpatient appointments for children with CP were not attended. Non‐attendance was associated with increasing age, socioeconomic disadvantage, previous non‐attendance, and recent rescheduled or cancelled appointments. Identifying specific barriers and interventions to improve access to outpatient services for these groups is needed.What this paper adds: Twelve per cent of scheduled appointments for children with cerebral palsy are not attended. Proportions of appointments not attended has increased over the last decade. Increasing age and socioeconomic disadvantage increase the likelihood of non‐attendance. Previous non‐attendance and recent cancelled or rescheduled appointments increase the likelihood of further non‐attendance.

Aim: To co‐design a social prescribing intervention (the EPIC‐CP programme: Equitable Pathways and Integrated Care in Cerebral Palsy) with children with cerebral palsy (CP), their families, and clinicians to address unmet social needs.Method: The study was conducted (August 2021 to March 2023) at the paediatric rehabilitation departments of the three tertiary paediatric hospitals in New South Wales, Australia. Eligible participants attended or worked at one of the departments, including children with CP, parents/caregivers, and clinicians. Mixed‐methods co‐design was used in intervention co‐production and prototyping. The project was overseen by research advisors with lived experience of CP.Results: More than 200 participants contributed to the co‐design research. Families experienced a substantial burden of unmet social needs. Co‐designed interventions involved systematic identification of unmet social needs with (1) targeted community resources and (2) engagement with a ‘community linker’ who supported children/young people and their families to access health, education, and social services that matched their identified needs and preferences. Research participants co‐developed the programme logic model and prototype. This was piloted in research action cycles and iteratively refined until consensus was achieved.Interpretation: We co‐designed a social prescribing programme responsive to the needs of its end‐users and purposefully developed to be embedded in the Australian health setting. A pilot randomized controlled trial will further evaluate this intervention.