| Description |
Background: Social determinants of health (SDoH) are the environmental conditions, material attributes, and patterns of social engagement that shape an individual's health exposures and health behaviors, contribute to an individual's health outcomes, and can place individuals at risk for poor health outcomes. Social needs can act as a surrogate for screening for SDoH and affect individuals in all communities. However, there is limited understanding of how sociodemographic and geospatial factors impact reported unmet social needs. Objective: To identify specific patient clusters with their demographic information and geospatial factors that impact their health behavior and their reported needs in the SDoH survey. Methods: We surveyed a convenience sample of English- and Spanish-speaking caregivers of patients <18-years-old presenting to Primary Children's Hospital Emergency Department (PCH ED) in Salt Lake City, Utah, with the help of the University of Utah Undergraduate Academic Associate program. In the caregiver's selfselected language, the pediatric version of the Screening for Intensifying Community Referrals for Health (p-SINCERE) assessed the patient demographics and 10 areas of social needs. The primary outcome was to identify specific patient clusters with their demographic information and geospatial factors that impact their health behavior and their reported needs. Chi-square test and Excel statistical package were used to analyze the reported needs from the p-SINCERE survey in relationship to geospatial factors of population metrics established by the Utah Department of Health's Health Improvement Index (HII). The p-SINCERE dataset used was part of the ongoing work of the SDoH research team at PCH ED. Results: Between 09/27/2021 and 01/26/2022 there was a total of 3,587 caregivers enrolled in the study. Of the 3,587 eligible caregivers, the selected language of English was selected for 3,206 (89.3%) and Spanish selected for 381 (10.6%). There were 3,075 English speakers and 342 Spanish speakers who consented to complete the study. There were 1,755 enrolled caregivers (48.9%) who reported ≥1 unmet social need (USN). A significant association was shown across the 10 items in the survey. There was a significant difference (p<0.01) between English- and Spanish-speaking caregivers for responding "yes" and "decline to answer". There was a significant relationship between the race/ethnicity of the child and USN as well as the child's insurance status and USN. There was no significant difference shown between Hispanic identification and the presence/absence of social needs. Out of 70 zip codes provided, 21 had a significant cluster and 11 of the 21 had a Small Area Rating of High/Very High on the HII showing that there are health disparities in those areas. Conclusion: This study suggests that a person's zip code and social factors may be a better predictor of health based on the scope of our data. Furthermore, it was found that there was a higher prevalence of unmet social needs in relation to the child's race/ethnicity (Latinx, Black/African American, African, Native American, and Pacific Islander) and insurance status (those with public insurance or no insurance). This study iv highlights the need for social screening in healthcare settings and referral to community resources that help mitigate sociodemographic and geospatial influencers. |
