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Does Parental Report of Having a Medical Home Attenuate the Negative Association Between Unmet Basic Needs and Health
Rebecca Webb1, Anna Whitham1, Yorghos Tripodis2
1Boston University School of Medicine, Boston Medical Center, Boston, MA, USA.
Insights
A medical home did not improve health outcomes for low-income children facing unmet basic needs. This study found no evidence that a medical home mitigates the negative health impacts of social determinants.
Area of Science:
- Pediatrics
- Health Services Research
- Social Determinants of Health
Background:
- The impact of adverse social determinants on low-income child health is not fully understood.
- Investigating the role of the medical home in mitigating these effects is crucial.
Purpose of the Study:
- To determine if the medical home model lessens the association between unmet basic needs and health status in low-income children.
- To examine the potential moderating effect of the medical home on child health outcomes.
Main Methods:
- Secondary data analysis of the 2011-12 National Survey of Children's Health (NSCH).
- Analysis restricted to children below 200% federal poverty level (n=26,974).
- Multivariable logistic regression used to model child health, incorporating unmet basic needs and medical home status.
Main Results:
- Low-income children with unmet basic needs had significantly lower odds of reporting "excellent/very good" health.
- The presence of a medical home did not alter the negative association between unmet needs and child health.
- Statistical analysis showed no significant modification effect of the medical home (P=0.97).
Conclusions:
- Parent-reported medical home status did not attenuate the adverse relationship between unmet basic needs and the health of low-income children.
- Findings suggest that current medical home models may not effectively buffer the health consequences of social determinants for this population.
Abstract:
Background. It is unknown whether the medical home reduces the impact of adverse social determinants on low-income child health. Objective. To examine whether the medical home attenuates the association between unmet basic needs and health for low-income children. Design/Methods. Secondary data analysis of the 2011-12 NSCH restricted to <200% FPL children (n = 26 974). Multivariable logistic regression modeled child health with unmet basic needs to examine the effect modification of the medical home. Results. Low-income children with unmet needs had lower odds of "excellent/very good" health compared to children without unmet needs, regardless of the medical home [aOR = 0.78 (0.61-0.99) vs aOR = 0.77 (0.63-0.94), P = .01), respectively]. The medical home did not modify the negative association between unmet basic needs and "excellent/very good" child health (P = .97). Conclusion. Having a medical home per parental report did not attenuate the negative relationship between unmet basic needs and lowincome child health.
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