Socioeconomic Indicators and Low Body Mass Index Outcome Among Adolescents and Young Adults With Social Risks

To describe clinical characteristics among adolescents and young adults with isolated low body mass index (BMI) and identify socioeconomic indicators in the lived environment associated with this outcome.

Using our electronic health record, we conducted a retrospective case-control study that included 135 adolescents and young adults ages 13 to 21 from an under-resourced neighborhood of Massachusetts with isolated diagnoses of failure to thrive or underweight status. We used the Centers for Disease Control and Prevention weight classification to allocate patients into low and normal BMI categories. We used chi-square and Fisher exact tests to compare differences in clinical characteristics and neighborhood socioeconomic indicators by BMI outcome and a 2-sample test of proportions or logistic regression to calculate the effect estimate and 95% confidence interval.

Forty percent of the participants with low BMI were diagnosed with malnutrition and required nutritional supplements. Low BMI finding was positively associated with depression, anxiety, and unmet social drivers of health-primarily driven by housing insecurity.

Our findings indicate that a significant proportion of adolescents and young adults with low BMI experience housing insecurity and unmet social needs in their lived environment and suffer from malnutrition at a critical time of their growth and development. Further research is needed to understand the role of the lived environment and outcome of low BMI, the underlying mechanisms at play, and its impact on adolescents' and young adults' growth and development.