Adverse Social Determinants of Health and Gaps in Care Coordination Among Children

Area of Science:

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

Background:

• Care coordination (CC) is vital for children's health.
• Gaps in CC can negatively impact health outcomes.
• The influence of adverse social determinants of health (SDoH) on CC gaps is not well understood.

Purpose of the Study:

• To determine the association between exposure to adverse SDoH and experiencing gaps in CC among children.
• To quantify the impact of specific SDoH factors on CC gaps in a national sample.

Main Methods:

• Utilized a representative national sample of children.
• Analyzed data to assess the relationship between various adverse SDoH and the presence of CC gaps.
• Employed statistical methods including adjusted odds ratios (aOR) and confidence intervals (CI).

Main Results:

• Children with inadequate or no health insurance showed a significantly higher likelihood of CC gaps (aOR = 2.41, 95% CI: 2.19-2.66).
• Children residing in disadvantaged neighborhoods were more likely to experience CC gaps (aOR = 1.53, 95% CI: 1.33-1.75).
• A higher cumulative count of adverse SDoH was strongly associated with increased odds of CC gaps (aOR = 2.17, 95% CI: 1.85-2.53).

Conclusions:

• Adverse SDoH, including lack of insurance and neighborhood disadvantage, are significantly associated with greater gaps in children's care coordination.
• Interventions aimed at improving CC for children must integrate strategies to address underlying adverse SDoH.
• Future research should explore targeted interventions for vulnerable populations to mitigate SDoH-related CC gaps.