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Developmental Disabilities Are Associated with Higher Unmet Social Needs in Children
Alexandra L Falkenberg1, Samantha R Levano2, Miya Lemberg3
1Rose F. Kennedy Children's Evaluation and Rehabilitation Center, Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY.
Insights
Pediatric patients with developmental disabilities (DD) are more than twice as likely to report health-related social needs (HRSN) compared to primary care patients. Health systems should implement strategies to identify and address these critical needs in children with DD.
Area of Science:
- Pediatric Health
- Health Disparities
- Social Determinants of Health
Background:
- Health-related social needs (HRSN) significantly impact pediatric health outcomes.
- Developmental disabilities (DD) may be associated with increased vulnerability to HRSN.
- Understanding HRSN prevalence in pediatric populations is crucial for equitable care.
Purpose of the Study:
- To compare the likelihood of reporting at least one HRSN between pediatric patients with developmental disabilities (DD) and those in primary care (PC).
- To quantify the association between DD status and the self-reporting of HRSN in a pediatric cohort.
Main Methods:
- Cross-sectional study in a large urban health system, comparing patients with DD (n=1420) and PC patients (n=32,143).
- Utilized a standardized HRSN screener assessing housing, utilities, food, transportation, cost, care, and legal needs.
- Employed multivariable logistic regression analysis, adjusting for sociodemographic factors.
Main Results:
- 30.0% of pediatric patients with DD reported at least one HRSN, compared to 12.6% of PC patients.
- Pediatric patients with DD had 2.49 times greater odds of reporting at least one HRSN (95% CI: 2.20, 2.82).
Conclusions:
- Pediatric patients with developmental disabilities face a significantly higher burden of health-related social needs.
- Health systems must develop targeted workflows to identify and address HRSN in children with DD.
- Further research is warranted to explore underlying factors contributing to this disparity.
Objective:
To compare the likelihood of self-reporting at least one health-related social need (HRSN) for pediatric patients with developmental disabilities (DD) compared with pediatric primary care (PC) patients.
Study Design:
This cross-sectional study was conducted in a large urban health system in the Bronx, New York, between May 2023 and August 2024. We identified a cohort of patients ≤21 years old with DD (n = 1420), at an urban center that specializes in serving children with DD, who completed a standardized HRSN screener to assess housing insecurity, housing quality, utility needs, food insecurity, health care transportation needs, health care cost needs, child or adult care needs, and legal needs. We also identified a cohort of pediatric PC patients who completed the HRSN screener at 1 of 14 outpatient PC practices (n = 32 143). We completed a retrospective analysis using electronic health record data. Multivariable logistic regressions were conducted to estimate the likelihood of self-reporting at least 1 HRSN in regard to a patient's DD status, while adjusting for sociodemographic characteristics.
Results:
Approximately 30.0% (n = 426) of DD patients self-reported at least 1 HRSN compared with 12.6% (n = 4064) of PC patients. In the multivariable analysis, DD patients demonstrated 2.49 (2.20, 2.82) greater odds of having at least 1 HRSN compared with PC patients.
Conclusions:
Health systems should consider developing workflows that identify and address HRSNs for pediatric patients with DD. Further research is needed to understand the factors contributing to the increased HRSN prevalence observed in patients with DD.
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