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Updated: Oct 26, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Social Determinants of Health Needs and Pediatric Health Care Use
Rose Hardy1, Samantha Boch2, Hannah Keedy1
1Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH.
Insights
Families reporting social needs, such as food or transportation insecurity, used less preventive care and more emergency services for their children. Addressing these social determinants of health is crucial for improving pediatric health outcomes.
Area of Science:
- Pediatric Health Services Research
- Social Determinants of Health
- Health Equity
Background:
- Social needs are increasingly recognized as critical factors influencing child health and healthcare utilization.
- Primary care settings offer a unique opportunity to identify and address social needs impacting pediatric patients.
Purpose of the Study:
- To investigate the association between family-reported social needs and patterns of healthcare use in children and adolescents.
- To determine if social needs correlate with differences in emergency department visits, inpatient stays, and preventive care.
Main Methods:
- A large cohort of 56,253 children and youths (0-21 years) receiving primary care was analyzed.
- Propensity score weighting was used to examine associations between reported social needs (housing, utilities, transportation, food) and healthcare use.
- Outcomes included emergency department visits, inpatient stays, social work visits, and well-child visits within 6 months pre- and post-screening.
Main Results:
- 12.0% of families reported at least one social need, with 28% deemed urgent. Food and transportation needs were most prevalent.
- Children with social needs had higher rates of emergency department and inpatient visits both before and after screening.
- Children under 2 years with social needs were less likely to complete well-child visits post-screening.
Conclusions:
- Family-reported social needs are significantly associated with reduced preventive care and increased emergency healthcare utilization in pediatric populations.
- These findings highlight the need for integrated approaches within primary care to support families facing social challenges.
- Addressing social determinants of health is essential for improving pediatric health outcomes and reducing healthcare disparities.
Objective:
To examine the associations between family-reported social needs in primary care settings and pediatric health care use.
Study Design:
Data were obtained for a sample of 56 253 children and youths (age 0-21 years) who received primary care at a large hospital-based pediatric institution between June 2018 and October 2019 to estimate a propensity score for the probability of being seen in a primary care clinic. Inverse probability weighted regression specifications were used to examine the associations between reported social needs and health care use. Families were asked about 4 social needs: housing, utilities, transportation, and food. Outcomes included the number of Emergency Department (ED), inpatient, social work, and well-child visits (only for those aged 0-2 years) in the 6 months before and after needs screening.
Results:
Overall, 12.0% of the families reported a general social need, with 28% of those needs identified as urgent. Food and transportation needs were most common. Patients with needs were more likely to have an ED or inpatient visit at 6 months prescreening and 6 months postscreening compared with those without needs. Among children aged <2 years, those with a social need were less likely to have completed a well-child visit at 6 months postscreening compared with those without a need.
Conclusions:
Social needs are linked to less preventive care use and greater reliance on emergency care services. Understanding how to better assist families in need requires greater attention.
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