Prevalence of Social Determinants of Health and Associations of Social Needs Among United States Adults, 2011–2014

Kim, Eun Ji; Abrahams, Sara; Uwemedimo, Omolara; Conigliaro, Joseph

doi:10.1007/s11606-019-05362-3

Cited by 8 publications

(9 citation statements)

References 5 publications

(4 reference statements)

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“…Financial strain has been identi ied as a major factor affecting adults' healthcare decision-making, as well as caregiver depression [28,29]. In our study, the effect of these variables may have been reduced by demographics and other SDH needs because of potential correlations of inancial hardship [30] and lack of childcare with measures related to low income within our dataset.…”

Section: Discussionmentioning

confidence: 82%

Associations of adverse social determinants of health with missed well-child visits and the role of caregiver social support

Roberts¹,

Kim²,

Martinez³

et al. 2021

J Adv Pediatr Child Health

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Objective: To examine the association between adverse social determinants of health (SDH) and missed well-child visits and the interaction with the level of caregiver social support. Methods: This is a secondary data analysis of data collected from a SDH screening program conducted during well-child visits with referral, navigation and follow-up services for patients. We included 573 adult caregivers who accompanied patients aged 0-5 years to well-child visits and completed the screening from August 2017 to May 2018. The caregivers reported financial hardship, food insecurity, housing challenges, childcare difficulty, transportation issues, insurance difficulty, job difficulty, and education needs. Our primary outcome was a no-show (i.e., missed) to a well-child visit. Social support was dichotomized as low or high. Results: Among 573 patients who completed the screening, 335 patients (76.4%) had at least one social need. Financial hardship (p = 0.006), housing instability (p = 0.002), and no/poor childcare (p = 0.03) were associated with missed well-child visits. In multivariable regression analysis, having Medicaid (aOR = 1.91 [1.17-3.10]) and unstable housing (aOR = 6.79 [1.35-34.70]) were both associated with missed well-child visits. However, when social support was added to the multivariable logistic model, both Medicaid and unstable housing were no longer associated with missed well-child visits. Conclusion: Adverse SDH such as financial hardship, housing instability, and childcare difficulty were associated with missed well-child visits. However, with the addition of social support, this association was no longer significant. This study supports the hypothesis that high social support may mitigate the association between well-child visits among families experiencing adverse SDH.

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Section: Discussionmentioning

confidence: 82%

Associations of adverse social determinants of health with missed well-child visits and the role of caregiver social support

Roberts¹,

Kim²,

Martinez³

et al. 2021

J Adv Pediatr Child Health

View full text Add to dashboard Cite

show abstract

“…A study based on the National Health and Nutrition Examination Survey (NHANES) concluded that 25% of American adults had 1 social determinant while 30% had 2 or more determinants. 10 Another study of incident stroke estimated that about 7400 participants had 1 social determinant while 12 000 had 2 or more determinants. 11 A novel aspect of our study is identifying clusters of social determinants that occur together more often than would be expected if each determinant were independent of each other.…”

Section: Discussionmentioning

confidence: 99%

Clustering of Social Determinants of Health Among Patients

Schiltz

Chagin

Sehgal

2022

J Prim Care Community Health

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Introduction/Objectives: Many health systems screen patients for social determinants of health and refer patients with social needs to community organizations for assistance. Understanding how social determinants cluster together may help guide assistance programs. Methods: This study examined patients screened by The MetroHealth System in Cleveland, Ohio for 9 social determinants, including food insecurity, financial strain, transportation limitations, inability to pay for housing or utilities, intimate partner violence, social isolation, infrequent physical activity, daily stress, and lack of internet access. Clustering analyses were performed to determine which combination of social determinants occurred together more often than would be expected if each determinant were independent of each other. Results: Among 23 161 screened patients, there were 19 dyads, 13 triads, and one tetrad of social determinants that clustered together. The most prevalent triad of food insecurity, social isolation, and inability to pay for housing or utilities occurred among 1095 patients but would be expected to occur among 284 patients, for an observed/expected ratio of 3.85 (95% confidence interval 3.64-4.07). In multivariate analyses, younger, Black, and lower income patients were 2 to 3 times more likely to have this triad compared to older, White, and wealthier patients. Conclusions: Social determinants of health frequently cluster together, and such clustering is associated with patient demographic characteristics. Further work is needed to determine how social determinant clusters impact health and cost outcomes and to develop programs that can address multiple co-existing social needs.

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“…We identified seven domains of adverse SDH: low education, low income, lack of health insurance, food insecurity, poor housing, no/ limited employment status, and limited English proficiency. 3 We performed descriptive statistics on sociodemographic characteristics and chi-square tests of similarity. We ran multivariate logistic regression models to identify characteristics associated with each of the diabetic standards of care.…”

Section: Methodsmentioning

confidence: 99%

“…This is important to elucidate, as the presence of one adverse SDH is frequently associated with the presence of others. 3 As the incidence and prevalence of diabetes increase, there is a need to comprehensively investigate adverse SDH that could contribute to this phenomenon. 4 Using nationally representative data, we examined associations between seven domains of adverse SDH and the control and diagnosis of diabetes.…”

Section: Introductionmentioning

confidence: 99%

Significance of Multiple Adverse Social Determinants of Health on the Diagnosis, Control, and Management of Diabetes

et al. 2020

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Prevalence of Social Determinants of Health and Associations of Social Needs Among United States Adults, 2011–2014

Cited by 8 publications

References 5 publications

Associations of adverse social determinants of health with missed well-child visits and the role of caregiver social support

Associations of adverse social determinants of health with missed well-child visits and the role of caregiver social support

Clustering of Social Determinants of Health Among Patients

Significance of Multiple Adverse Social Determinants of Health on the Diagnosis, Control, and Management of Diabetes

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