Medical Student Wright State University Boonshoft School of Medicine Dayton, Ohio, United States
Background: Families' unmet social needs (USN) are related to adverse outcomes for their children. This study examines factors related to families' USN in primary care settings to refine our understanding of family characteristics related to their self-reported USN. Objective: To identify factors related to families' USN. Design/Methods: This was a cross sectional study of a convenience sample. Surveys were given to English speaking primary caregivers (PCGs) of index children less than 19 years old in waiting rooms of primary care offices within the Southwestern Ohio Ambulatory Research Network (SOAR-Net), a regional practice-based research network, from January to June 2023. The survey included validated questionnaires: Maternal Social Support Index (MSSI), Social Capital Scale, Rand Depression Screener, Children with Special Health Care Needs (CSHCN) Screener, Medical Expenses of Children Survey, a 10-item social needs screener, and demographics. Comparisons between PCGs with no USN vs. at least 1 USN were made with chi-square tests and multiple logistic regression (MLR). Results: Of 534 PCGs who completed the survey (response rate= 78%), 49% reported at least one USN. 59% of index children had public health insurance, 54% were boys, and 27% screened positive for a CHC. 73% of PCGs were white, 66% were married or in a couple relationship, 55% reported household income <$50,000, and 33% had a positive depression screen (DS). 63% of PCGs raising a child with a CHC reported at least one USN vs. 42% of PCGs NOT raising a child with a CHC (p < 0.001). 67% of unmarried PCGs reported an USN vs. 39% of married or in a couple relationship (p < 0.001). 69% of PCGs with a positive DS reported an USN vs. 39% of PCGs with a negative DS (p < 0.001). Child’s overall health ranked by their PCGs as fair/poor was a strong independent predictor of USN (adjusted odds ratio = 14.62, 95% confidence interval 1.64-130.62) vs. children whose overall health was ranked as excellent when MLR was used to adjust for a number of social and demographic variables.
Conclusion(s): Almost half of the sample reported at least one USN. Overall, household income <$50,000, index child identified as being in fair/poor health, underinsured status, MSSI score below the median, and positive depression screen were associated with USN. Future research should longitudinally examine how variations in elements of caregivers’ social support and community involvement are related to caregivers’ perceptions of their social needs.
