478 - Prevalence and Correlates of Families' Unmet Social Needs in Primary Care

Publication Number: 4469.478

Sophia D. Danchine, Wright State University Boonshoft School of Medicine, Dublin, OH, United States; Sritha Donepudi, Wright State University Boonshoft School of Medicine, Beavercreek, OH, United States; Kristen Waters, Wright State University Boonshoft School of Medicine, Dayton, OH, United States; Serena Kaul, Wright State University Boonshoft School of Medicine, Cincinnati, OH, United States; John Pascoe, Wright State University Boonshoft School of Medicine, Dayton, OH, United States

Background: Children of families facing unmet social needs (USNs) experience higher rates of adverse outcomes compared to those not experiencing USNs. This study aimed to identify factors associated with families’ USNs as reported by parents or guardians at their children’s pediatric primary care visits.

Objective: To examine the demographic and socioeconomic factors associated with USNs reported by families at primary care venues.

Design/Methods: This cross-sectional study recruited English-speaking primary caregivers (PCGs) of children < 18 years from the Southwestern Ohio Ambulatory Research Network (SOAR-Net) who were surveyed between January 2023 and August 2024. Surveys included the Maternal Social Support Index (MSSI), Social Capital Scale, RAND Depression Screener, Children with Special Health Care Needs Screener, Medical Expenses of Children Survey, a 10-item social needs screener, and demographics. Data were analyzed with Chi-square or Fisher’s Exact tests, adjusted logistic regression, and ANOVA.

Results: Among 1,167 respondents (78% response rate), 1,114 provided complete data. Primary caregivers (PCGs) were predominantly mothers (79.9%) or fathers (13.6%), White (72.0%) or Black (16.0%), and had an associate degree or less (65.1%). The mean index child’s age was 6.4 (5.3) years, and 52.4% were female. Underinsurance was strongly associated with unmet social needs (USNs), which affected 17.1% of those with 0 USNs, 12.9% with 1 USN, and 70.1% with 2 USNs (p < 0.001). Rates of positive depression screens also rose with USNs (9.6%, 34.0%, 56.4% respectively; p< 0.001). Mean MSSI scores decreased on a gradient with increasing USNs: 25 (6) for 0 USNs, 23 (6) for 1 USN, and 19 (7) for ≥2 USNs (p < 0.001). Adjusted logistic regression, that was controlled for demographics and other survey measures, showed that the risk of underinsurance was nearly 10 times higher for families with ≥2 USNs compared to those with 0 USNs (AOR 9.85; 95% CI: 4.05–23.93; p< 0.001).

Conclusion(s): Nearly half (46.8%) of PCGs reported one or more USNs. Families with ≥2 USNs had higher rates of underinsurance, lower income, and less social support. Child underinsurance was related to USN reporting, even after controlling for demographics and other survey measures. As USNs increased, caregivers showed progressively lower social support with higher positive depression screening rates. These findings highlight the complex interplay among social factors in pediatric primary care. Future research should explore the stability of these associations over time.