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Characterizing Energy Insecurity: Utility Shut-Off Protection Requests in Pediatric Primary Care.

Nicole C de Paz1, Clement J Bottino, Corinna J Rea

  • 1Author Affiliations: Division of General Pediatrics, Boston Children's Hospital (Dr de Paz, Dr Bottino, Dr Rea, and Dr Shah), Harvard Medical School (Dr de Paz, Dr Bottino, Dr Rea, and Dr Shah), Department of Pediatrics, Atrius Health (Dr de Paz), Department of Accountable Care and Clinical Integration (Dr Shah), Office of Health Equity and Inclusion (Dr Shah), Boston Children's Hospital, and Sandra L. Fenwick Institute of Pediatric Health Equity and Inclusion (Dr Shah), Boston, Massachusetts.

The Journal of Ambulatory Care Management
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Summary
This summary is machine-generated.

Families with public insurance and minority children frequently requested utility shut-off protection letters. Repeat requests highlight chronic energy insecurity, necessitating equitable pediatric care solutions.

Keywords:
energy insecurityhealth-related social needshousing insecuritypediatricsprimary caresocial determinants of health

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Area of Science:

  • Pediatric Primary Care
  • Social Determinants of Health
  • Health Equity

Background:

  • Household energy insecurity affects over a third of US households, impacting health.
  • Utility shut-off protection letters are a tool to address acute energy insecurity.
  • Limited research exists on these letters in pediatric primary care.

Purpose of the Study:

  • Characterize utility shut-off protection letter requests in a pediatric primary care setting.
  • Identify predictors of utility letter requests among pediatric patients.

Main Methods:

  • Retrospective case-control study.
  • Utilized electronic health and administrative data from a large pediatric clinic in Boston, MA.
  • Analyzed 1,694 requests from 704 patients between 2018-2019.

Main Results:

  • 57% of families made repeat utility letter requests, indicating chronic need.
  • Public insurance, younger age, Black/Hispanic ethnicity, and well-child visits predicted requests.
  • Lower medical complexity and non-English preferred language showed negative associations.

Conclusions:

  • Letter requests align with national energy insecurity trends, with higher use by public insurance and minority families.
  • Concerns exist regarding equitable access for non-English speaking families.
  • Frequent repeat requests highlight the chronic nature of energy insecurity, urging policy interventions for equitable support.