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Social Risks and Health Care Utilization Among a National Sample of Children With Asthma

Jordan Tyris1, Jonathan Rodean2, John Kulesa1

  • 1Division of Hospital Medicine (J Tyris, J Kulesa, G Dixon, P Bhansali, T Gayle, D Akani, M Magyar, N Tamaskar, and K Parikh), Children's National Hospital, Washington, DC; Department of Pediatrics (J Tyris, J Kulesa, G Dixon, P Bhansali, T Gayle, D Akani, M Magyar, N Tamaskar, and K Parikh), George Washington University School of Medicine and Health Sciences, Washington, DC.

Academic Pediatrics
|August 8, 2022
PubMed

Insights

Social risks are common in children with asthma and linked to higher healthcare use. Addressing these social determinants of health can reduce asthma-related healthcare needs.

Area of Science:

  • Pediatric Health
  • Social Determinants of Health
  • Health Services Research

Background:

  • Previous research linked social risks to healthcare utilization in pediatric asthma using single-center data.
  • A national perspective is needed to understand the broader impact of social risks on children with asthma.

Purpose of the Study:

  • To assess the association between social risks and healthcare utilization in a nationally representative sample of children with asthma.
  • To identify specific social risks contributing to increased healthcare utilization in this population.

Main Methods:

  • Cross-sectional study using the 2018-2019 National Survey of Children's Health.
  • Identified children aged 2-17 with asthma, classifying 18 social risks into 5 Healthy People 2030 social determinants of health domains.
  • Assessed associations between individual social risks and total number of social determinants of health domains with caregiver-reported healthcare utilization.

Main Results:

  • The study included 8.05 million children with asthma; 96% experienced at least one social risk.
  • Fourteen social risks across all 5 social determinants of health domains were significantly associated with increased healthcare utilization.
  • Experiencing discrimination (aOR 3.26), receiving free/reduced lunch (aOR 2.16), and being a victim of violence (aOR 2.11) showed the highest adjusted odds ratios for healthcare utilization.

Conclusions:

  • Social risks are highly prevalent in children with asthma nationwide.
  • These social risks are significantly associated with increased healthcare utilization, contributing to pediatric asthma morbidity.
  • Interventions targeting social determinants of health may mitigate healthcare utilization and improve outcomes for children with asthma.
Abstract

Keywords:
asthmahealth disparitieshealth equitysocial determinants of health

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