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Research Studies is a compilation of published research articles funded by ��Ƶor authored by ��Ƶresearchers.

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Linton SL, Leifheit KM, McGinty EE

Association between housing insecurity, psychological distress, and self-rated health among US adults during the COVID-19 pandemic.

This research letter describes a survey study conducted to examine the association between housing insecurity and health during the COVID-19 pandemic. Data used was from wave 3 of the Johns Hopkins COVID-19 Civic Life and Public Health Survey, which was conducted online from November 11-30, 2020 using the National Opinion Research Center’s AmeriSpeak panel. The survey included 1218 participants who were 51% female, 560 participants aged 30 to 54 years, 549 participants aged 55 years or older; 13% self-identified as Hispanic, 13% self-identified as non-Hispanic Black, and 69% self-identified as non-Hispanic White. In November 2020, 128 participants (12%) reported housing insecurity. Among survey participants reporting housing insecurity, 42 reported being behind on housing payments, 55 reported having little to no confidence in their ability to make their next housing payment, and 31 reported both. Renters had disproportionately higher housing insecurity than homeowners, as did those were non-Hispanic Black race, were aged 30 to 54 years, earned less than $35,000 in 2019, lived with children, or resided in metropolitan counties. Forty-six percent of participants reported severe to moderate psychological distress and 18% reported fair to poor health. Participants with housing insecurity reported higher distress (57% vs 45%) and lower self-rated health (30% vs 16%). The association between housing insecurity and lower self-rated health was found to be statistically significant, while the association between housing insecurity and higher distress was not.

AHRQ-funded; HS000046.

Citation: Linton SL, Leifheit KM, McGinty EE . Association between housing insecurity, psychological distress, and self-rated health among US adults during the COVID-19 pandemic. JAMA Netw Open 2021 Sep;4(9):e2127772. doi: 10.1001/jamanetworkopen.2021.27772..

Keywords: COVID-19, Health Status, Stress, Social Determinants of Health

Parker MG, Garg A, Brochier A

Approaches to addressing social determinants of health in the NICU: a mixed methods study.

The objective of this study was to examine current approaches to addressing social determinants of health (SDOH) in the NICU and perceived appropriateness of a standardized screening and referral process. The investigators performed a mixed methods study in two Massachusetts safety-net NICUs. They concluded that current NICU assessment of SDOH was limited and use of a standardized screening and referral process could be useful.

AHRQ-funded; HS026370.

Citation: Parker MG, Garg A, Brochier A . Approaches to addressing social determinants of health in the NICU: a mixed methods study. J Perinatol 2021 Aug;41(8):1983-91. doi: 10.1038/s41372-020-00867-w..

Keywords: Social Determinants of Health, Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU)

Izadi Z, Li J, Evans M

Socioeconomic disparities in functional status in a national sample of patients with rheumatoid arthritis.

This longitudinal study looked at the association of socioeconomic disparities and functional status in a national sample of patients with rheumatoid arthritis (RA). This study used a cohort from the American College of Rheumatology’s Rheumatology Informatics System for Effectiveness (RISE) registry from 2016 to 2018. Analyses included all adult patients with a confirmed RA diagnosis and at least 1 functional status (FS) score documented. The Area Deprivation Index (ADI), a zip code-based indicator of poverty, was used as a proxy for socioeconomic status (SES). The cohort included 83,965 patients, of which 77% were women and 72% were non-Hispanic White. Mean age was 63.4 years. The probability of functional decline was 14.1% in the highest SES quintile and 18.9% in the lowest SES quintile. By all measures FS score was worse at lower SES levels.

AHRQ-funded; HS025638; HS024412.

Citation: Izadi Z, Li J, Evans M . Socioeconomic disparities in functional status in a national sample of patients with rheumatoid arthritis. JAMA Netw Open 2021 Aug 2;4(8):e2119400. doi: 10.1001/jamanetworkopen.2021.19400..

Keywords: Arthritis, Chronic Conditions, Disparities, Social Determinants of Health, Quality of Life

Nguyen KH, Fields JD JD, Cemballi AG

The role of community-based organizations in improving chronic care for safety-net populations.

Researchers conducted a multi-stakeholder qualitative study to capture the multi-level influences on health for those living in socio-economically deprived contexts. Participants were patients with chronic illnesses in San Francisco neighborhoods with high chronic disease rates, community leaders serving the same neighborhoods, or providers from San Francisco's public health care delivery system. The researchers identified several key themes. They concluded that their results contributed new evidence toward the community domain of the Chronic Care Model, and health care systems must intentionally partner with community-based organizations to address social determinants of health and improve community resources for chronic care management.

AHRQ-funded; HS026383.

Citation: Nguyen KH, Fields JD JD, Cemballi AG . The role of community-based organizations in improving chronic care for safety-net populations. J Am Board Fam Med 2021 Jul-Aug;34(4):698-708. doi: 10.3122/jabfm.2021.04.200591..

Keywords: Community Partnerships, Chronic Conditions, Social Determinants of Health, Care Management

Walter LA, Schoenfeld EM, Smith CH

Emergency department-based interventions affecting social determinants of health in the United States: a scoping review.

Emergency departments (EDs) function as the safety nets of the American health care system, caring for many vulnerable populations. ED-based interventions to assess social risk and mitigate social needs have been reported in the literature. However, the breadth and scope of these interventions have not been evaluated. As the field of social emergency medicine (SEM) expands, a mapping and categorization of previous interventions may help shape future research. In this study, the investigators sought to identify, summarize, and characterize ED-based interventions aimed at mitigating negative social determinants of health.

AHRQ-funded; HS025701; HS013852.

Citation: Walter LA, Schoenfeld EM, Smith CH . Emergency department-based interventions affecting social determinants of health in the United States: a scoping review. Acad Emerg Med 2021 Jun;28(6):666-74. doi: 10.1111/acem.14201..

Keywords: Emergency Department, Social Determinants of Health, Vulnerable Populations, Low-Income

Kirby JB, Bernard D, Liang L

��ƵAuthor: Kirby JB, Bernard D, Liang L

The prevalence of food insecurity is highest among Americans for whom diet is most critical to health.

This study investigated how widespread food insecurity is among people with diabetes among different insurance types and whether food assistance is adequately addressing the problem. The authors used new data on food insecurity from the ��ƵMEPS in 2016 and 2017. The sample was limited to adults ages 18-64 years. Results found the prevalence of food insecurity was much higher among adults with diabetes compared to those without diabetes (16% vs. 9%). People with diabetes who were taking insulin or who had eye or kidney complications had even rates of food insecurity at 19% and 22%, respectively. Food insecurity prevalence was much higher among Medicaid enrollees compared with those with other types of insurance. Nearly one-third of Medicaid enrollees with diabetes were food insecure, compared with 7% with private insurance. Medicaid enrollees with insulin-dependent diabetes had the highest food insecurity (44%), which is over 6 times higher than their counterparts with private insurance. They also found that a sizable fraction of people with diabetes who were food insecure were not receiving Supplemental Nutrition Assistance Program (SNAP) benefits. Over 80% of people with private insurance did not receive SNAP benefits, likely reflecting SNAP eligibility. However, even among Medicaid enrollees, 29% of people with diabetes were not receiving SNAP, and 68% of the uninsured were not receiving SNAP benefits. Even among SNAP recipients, over 40% of Medicaid enrollees with diabetes remained food insecure.

AHRQ-authored.

Citation: Kirby JB, Bernard D, Liang L . The prevalence of food insecurity is highest among Americans for whom diet is most critical to health. Diabetes Care 2021 Jun;44(6):e131-3132. doi: 10.2337/dc20-3116..

Keywords: Medical Expenditure Panel Survey (MEPS), Social Determinants of Health

Dickinson-Copeland CM, Immergluck LC, Britez M

Increased risk of sub-clinical blood lead levels in the 20-county metro Atlanta, Georgia area-a laboratory surveillance-based study.

This study looked at the distribution of blood lead levels (BLLs) in children aged 0-72 months and their associations with sociodemographic and area-level variables. Data from the Georgia Department of Public Health’s Healthy Homes for Lead Prevention Program surveillance data was used to describe the distribution of BLLs in metro Atlanta area children from 2010 to 2018. Residential addresses were geocoded and if BLLs were spatially clustered they were defined at “Hotspots”. Geographically defined hotspots for both clinical (≥5 µg/dL) and sub-clinical (2 to <5 µg/dL) BLLs diffused from the city-central area into suburban areas. Predictors of sub-clinical BLL levels from those with lower (<2 µg/dL) or higher ((≥5 µg/dL) BLLs included non-Medicaid insurance, the proportion of renters in a given geographical area, and proportion of individuals with a GED/high school diploma. Over half of the study children had sub-clinical BLL levels, a range that does not currently trigger public health measures but could result in adverse development outcomes if ignored.

AHRQ-funded; HS024338.

Citation: Dickinson-Copeland CM, Immergluck LC, Britez M . Increased risk of sub-clinical blood lead levels in the 20-county metro Atlanta, Georgia area-a laboratory surveillance-based study. Int J Environ Res Public Health 2021 May 13;18(10). doi: 10.3390/ijerph18105163..

Keywords: Newborns/Infants, Children/Adolescents, Social Determinants of Health, Public Health, Public Health

Lacson R, Shi J, Kapoor N

Exacerbation of inequities in use of diagnostic radiology during the early stages of reopening after COVID-19.

Researchers assessed diagnostic radiology examination utilization and associated social determinants of health during the early stages of reopening after state-mandated shutdown of nonurgent services because of COVID-19. They found that, despite resumption of nonurgent services, a marked decrease in radiology examination utilization persisted in all care settings post-shutdown, with more significantly decreased odds ratios for having examinations in inpatient and outpatient settings versus in the emergency department. Inequities worsened, with patients from communities with high rates of poverty, unemployment, and chronic disease having significantly lower odds of undergoing radiology examinations post-shutdown. Patients of Asian race and Hispanic ethnicity had significantly lower odds ratios for having examinations post-shutdown compared with White and non-Hispanic patients, respectively.

AHRQ-funded; HS024722.

Citation: Lacson R, Shi J, Kapoor N . Exacerbation of inequities in use of diagnostic radiology during the early stages of reopening after COVID-19. J Am Coll Radiol 2021 May;18(5):696-703. doi: 10.1016/j.jacr.2020.12.009..

Keywords: COVID-19, Disparities, Diagnostic Safety and Quality, Racial and Ethnic Minorities, Social Determinants of Health

Langston DM, Oslock WM, Paredes AZ

Hospital location and socioeconomic disadvantage of emergency general surgery patients.

This study’s purpose was to test the hypothesis that a hospital’s neighborhood disadvantage is associated with vulnerability of its emergency general surgery (EGS) patients. An area deprivation index (ADI), which is a neighborhood-level measure of disadvantage, and key characteristics of 724 hospitals in 14 states were linked to patient-level data in State Inpatient Databases. Hospitals in more disadvantaged areas disproportionately serve underserved EGS patient populations but are less likely to have robust resources for EGS care or train future EGS surgeons.

AHRQ-funded; HS022694.

Citation: Langston DM, Oslock WM, Paredes AZ . Hospital location and socioeconomic disadvantage of emergency general surgery patients. J Surg Res 2021 May;261:376-84. doi: 10.1016/j.jss.2020.12.028..

Keywords: Healthcare Cost and Utilization Project (HCUP), Surgery, Social Determinants of Health, Vulnerable Populations, Critical Care

Kim D, Lee Y, Thorsness R

Racial and ethnic disparities in excess deaths among persons with kidney failure during the COVID-19 pandemic, March-July 2020.

This national study estimated excess deaths for the kidney failure population by race and ethnicity from March 1 through August 1, 2020. Findings showed that, among the US kidney failure population, the number of excess deaths was 16% higher than expected, similar to reports for the general population. However, results showed that the relative increase in deaths among Black and Hispanic patients was more than 4-fold higher than that observed among White patients. The magnitude of these disparities was larger than corresponding relative ratios reported among COVID-19–associated deaths in the general population.

AHRQ-funded; HS028285.

Citation: Kim D, Lee Y, Thorsness R . Racial and ethnic disparities in excess deaths among persons with kidney failure during the COVID-19 pandemic, March-July 2020. Am J Kidney Dis 2021 May;77(5):827-29. doi: 10.1053/j.ajkd.2021.02.003..

Keywords: COVID-19, Racial and Ethnic Minorities, Disparities, Mortality, Kidney Disease and Health, Chronic Conditions, Social Determinants of Health

Duh-Leong C, Dreyer BP, Huang TT

Social capital as a positive social determinant of health: a narrative review.

This paper frames social capital, or the benefits that a child receives from social relationships, as a positive social determinant of health that helps children exposed to adversity achieve healthy outcomes across the life course. Findings showed that pediatric primary care practices play an important role in fostering social relationships between families, the health care system, and the community. Further research was recommended in order to develop definitional and measurement rigor for social capital, to evaluate interventions that may improve health outcomes through social capital, and to broaden understanding of how social relationships influence health outcomes.

AHRQ-funded; HS022236.

Citation: Duh-Leong C, Dreyer BP, Huang TT . Social capital as a positive social determinant of health: a narrative review. Acad Pediatr 2021 May-Jun;21(4):594-99. doi: 10.1016/j.acap.2020.09.013..

Keywords: Social Determinants of Health

Javalkar K, Robson VK, Gaffney L

Socioeconomic and racial and/or ethnic disparities in multisystem inflammatory syndrome.

Researchers characterized the socioeconomic and racial and/or ethnic disparities impacting the diagnosis and outcomes of multisystem inflammatory syndrome in children (MIS-C). They found that lower socioeconomic status or higher social vulnerability index, Hispanic ethnicity, and Black race independently increased risk for MIS-C. They recommended additional studies to target interventions to improve health equity for children.

AHRQ-funded; HS000063.

Citation: Javalkar K, Robson VK, Gaffney L . Socioeconomic and racial and/or ethnic disparities in multisystem inflammatory syndrome. Pediatrics 2021 May;147(5). doi: 10.1542/peds.2020-039933..

Keywords: Children/Adolescents, Social Determinants of Health, Disparities, Racial and Ethnic Minorities, Risk

Cullen D, Abel D, Attridge M

Exploring the gap: food insecurity and resource engagement.

Researchers investigated participant interest in referral and engagement with resources provided by pediatric health care institutions implementing food insecurity (FI) screens. They found that, through hospital-community partnership in an initial attempt to screen and offer direct-referral for FI, they elicited considerable interest among families for connection to resource agencies. However, there was a substantial gap between referral acceptance and ultimate connection with the resource agency.

AHRQ-funded; HS026116.

Citation: Cullen D, Abel D, Attridge M . Exploring the gap: food insecurity and resource engagement. Acad Pediatr 2021 Apr;21(3):440-45. doi: 10.1016/j.acap.2020.08.005..

Keywords: Children/Adolescents, Nutrition, Social Determinants of Health

Malhotra NA, Nevar A, Yearby R

Medicaid's EPSDT benefit: an opportunity to improve pediatric screening for social determinants of health.

This paper discusses the Early and Periodic Screening, Diagnostic, and Treatment (EPDST) benefit which is a key component of Medicaid policy intended to define an essential set of services provided to patients age 21 and younger. This qualitative review examines the extent to which EPSDT might be used to implement structured screening to identify environmental and social factors affecting children’s health. Semistructured interviews conducted in 2017 were triangulated with a review of the recent literature to describe how states currently consider the EPSDT benefit with respect to social determinants of health (SDOH) screening. Findings suggest that with sufficient stakeholder advocacy given the evidence supporting social determinants of health as “medically necessary”, EPSDT benefits could be considered as a funding source to incentivize the incorporation of SDOH screening into the basic package of well-child care.

AHRQ-funded; 233201600221A.

Citation: Malhotra NA, Nevar A, Yearby R . Medicaid's EPSDT benefit: an opportunity to improve pediatric screening for social determinants of health. Med Care Res Rev 2021 Apr;78(2):87-102. doi: 10.1177/1077558719874211..

Keywords: Children/Adolescents, Medicaid, Social Determinants of Health, Screening, Disparities, Policy

Fraiman YS, Litt JS, Davis JM

Racial and ethnic disparities in adult COVID-19 and the future impact on child health.

This article discusses the impact of the COVID-19 pandemic on children who are racial and ethnic minorities and the disproportionate harm to them. The authors urge that COVID-19-focused research consider racial and ethnic disparity. The paper discusses the lasting and intergenerational impact of COVID-19 on communities of color, especially children, due to increase in stress, material hardship, food insecurity, and long-term school readiness.

AHRQ-funded; HS000063.

Citation: Fraiman YS, Litt JS, Davis JM . Racial and ethnic disparities in adult COVID-19 and the future impact on child health. Pediatr Res 2021 Apr;89(5):1052-54. doi: 10.1038/s41390-021-01377-x..

Keywords: COVID-19, Children/Adolescents, Racial and Ethnic Minorities, Disparities, Health Status, Social Determinants of Health

Moriya AS, Xu L

��ƵAuthor: Moriya AS

The complex relationships among race/ethnicity, social determinants, and opioid utilization.

The objective of this study was to examine individual- and community-level factors associated with racial/ethnic differences in individuals' opioid prescription use. The investigators found that the average annual rate of any outpatient opioid prescription use was higher for non-Hispanic whites than for non-Hispanic blacks and Hispanics. The smaller difference between non-Hispanic blacks and whites was not explained by the differences in the risk factors, while almost all the difference between Hispanics and non-Hispanic whites could be explained by the differences in the means of the risk factors.

AHRQ-authored.

Citation: Moriya AS, Xu L . The complex relationships among race/ethnicity, social determinants, and opioid utilization. Health Serv Res 2021 Apr;56(2):310-22. doi: 10.1111/1475-6773.13619..

Keywords: Medical Expenditure Panel Survey (MEPS), Racial and Ethnic Minorities, Social Determinants of Health, Opioids, Medication, Disparities

Nguyen KH, Trivedi AN, Cole MB

Receipt of social needs assistance and health center patient experience of care.

The goal of this study was to examine the degree to which community health center patients report receiving social needs assistance and compares measures of access and quality. A nationally representative sample of 4,699 nonelderly adults receiving care at community health centers out of 12.6 million patients was studied from the 2014-2015 HRSA Health Center Patient Survey. Social needs assistance was defined as a patient receiving community health center assistance accessing social programs such as applying for government benefits or obtaining basic needs such as transportation, housing, or food. From the sample, 36% reported receiving social needs assistance. Patients receiving assistance were more likely to report their usual source of care as a community health center and to report perceived quality of care as “the best”. They were also significantly less likely to use emergency departments as their usual source of care.

AHRQ-funded; HS000011.

Citation: Nguyen KH, Trivedi AN, Cole MB . Receipt of social needs assistance and health center patient experience of care. Am J Prev Med 2021 Mar;60(3):e139-e47. doi: 10.1016/j.amepre.2020.08.030..

Keywords: Social Determinants of Health, Vulnerable Populations, Patient Experience, Quality of Care

Lee CI, Zhu W, Onega T

Comparative access to and use of digital breast tomosynthesis screening by women's race/ethnicity and socioeconomic status.

This study looked at access to digital breast tomography (DBT) versus regular mammography and whether women of minority race/ethnicity and lower socioeconomic status experienced lower DBT access during the early adoption period and persistently lower DBT use over time. This cross-sectional study included 92 geographically diverse imaging facilities across 5 US states, with over 2.3 million screening examinations performed among women aged 40 to 89 years from January 1, 2011, to December 31, 2017. Data were analyzed from June 2019, to August 2020. Women who used DBT increased for all women from 3.3% in 2011 to 82.6% in 2017. In 2012, Black, Hispanic, Asian American, and women with less than a high school education had lower DBT access compared to White women attending the same facility and also college graduates. Lower DBT access continued over time regardless of the number of years after facility-level DBT adoption.

AHRQ-funded; HS018366.

Citation: Lee CI, Zhu W, Onega T . Comparative access to and use of digital breast tomosynthesis screening by women's race/ethnicity and socioeconomic status. JAMA Netw Open 2021 Feb;4(2):e2037546. doi: 10.1001/jamanetworkopen.2020.37546..

Keywords: Cancer: Breast Cancer, Cancer, Imaging, Access to Care, Women, Social Determinants of Health, Racial and Ethnic Minorities, Screening

Loo S, Brochier A, Wexler MG

Addressing unmet basic needs for children with sickle cell disease in the United States: clinic and staff perspectives.

The purpose of this study was to assess pediatric hematology clinic staff's perspectives regarding barriers and facilitators in addressing unmet basic needs for children with sickle cell disease. Six focus groups were held at urban pediatric hematology clinics in the Northeastern region of the U.S. Four themes emerged: families of children with SCD have numerous unmet basic needs; clinic staff felt they had a role to play in addressing these needs; staff felt their ability to address these needs depended upon caregivers' capacity to act on staff recommendations; clinic staff's ability to address these needs was limited by organizational and systemic factors beyond their control. These findings have important implications for how best to address adverse social determinants of health for this vulnerable pediatric population so that urban-based pediatric hematology clinics can more equitably support families.

AHRQ-funded; HS022242.

Citation: Loo S, Brochier A, Wexler MG . Addressing unmet basic needs for children with sickle cell disease in the United States: clinic and staff perspectives. BMC Health Serv Res 2021 Jan 12;21(1):55. doi: 10.1186/s12913-020-06055-y..

Keywords: Children/Adolescents, Sickle Cell Disease, Chronic Conditions, Social Determinants of Health, Provider: Clinician, Provider: Physician, Provider, Urban Health

Bell N, Wilkerson R, Mayfield-Smith K

Community social determinants and health outcomes drive availability of patient-centered medical homes.

This study assessed the geographic distribution of patient-centered medical homes and the community social determinants and health outcomes that drive availability. The authors assessed spatial clusters of mental and physical health surveys; health behaviors; as well as premature mortality with clusters of medical home saturation and community socioeconomic characteristics. Counties having lower uninsured rates and lower poverty rates were more likely to have medical homes.

AHRQ-funded; HS026263.

Citation: Bell N, Wilkerson R, Mayfield-Smith K . Community social determinants and health outcomes drive availability of patient-centered medical homes. Health Place 2021 Jan;67:102439. doi: 10.1016/j.healthplace.2020.102439..

Keywords: Social Determinants of Health, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Outcomes

Hammad Mrig E

Integrating fundamental cause theory and Bourdieu to explain pathways between socioeconomic status and health: the case of health insurance denials for genetic testing.

This paper proposes that Pierre Bourdieu's theories of capital and symbolic power can be integrated with fundamental cause theory to address limitations in the latter theory, making it more useful in health disparities research. This work deepens appreciation for the durable relationship between socioeconomic status and health. Study results reveal the multiple and complex mechanisms that play a role in access to healthcare services, which has significant implications for how we think about the role of health policy in addressing health disparities.

AHRQ-funded; HS017589.

Citation: Hammad Mrig E . Integrating fundamental cause theory and Bourdieu to explain pathways between socioeconomic status and health: the case of health insurance denials for genetic testing. Sociol Health Illn 2021 Jan;43(1):133-48. doi: 10.1111/1467-9566.13195..

Keywords: Social Determinants of Health, Disparities, Health Insurance, Access to Care, Genetics, Policy

Kostelanetz S, Di Gravio C, Schildcrout JS

Should we implement geographic or patient-reported social determinants of health measures in cardiovascular patients.

The authors compared patient-reported social determinants of health (SDOH) to the Brokamp Area Deprivation Index (ADI) and then evaluated the association of patient-reported SDOH and ADI with mortality in patients with cardiovascular disease (CVD). They found that the Brokamp ADI is associated with mortality in hospitalized patients with CVD. They recommended that, in the absence of available patient-reported data, hospitals implement the Brokamp ADI as an approximation for patient-reported data to enhance risk stratification of patients with CVD.

AHRQ-funded; HS026122.

Citation: Kostelanetz S, Di Gravio C, Schildcrout JS . Should we implement geographic or patient-reported social determinants of health measures in cardiovascular patients. Ethn Dis 2021 Winter;31(1):9-22. doi: 10.18865/ed.31.1.9..

Keywords: Social Determinants of Health, Cardiovascular Conditions, Mortality, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice

Fraiman YS, Wojcik MH

The influence of social determinants of health on the genetic diagnostic odyssey: who remains undiagnosed, why, and to what effect?

This review article synthesizes the available evidence regarding population disparities in genetic testing for pediatric rare disease diagnosis and identifies gaps in care. The influence of social determinants of health is known, but this study’s goal is to examine the prevalence and nature of disparities in diagnostic testing. It synthesizes the available evidence regarding disparities, defining the need for further, prospective studies.

AHRQ-funded; HS000063.

Citation: Fraiman YS, Wojcik MH . The influence of social determinants of health on the genetic diagnostic odyssey: who remains undiagnosed, why, and to what effect? Pediatr Res 2021 Jan;89(2):295-300. doi: 10.1038/s41390-020-01151-5..

Keywords: Children/Adolescents, Social Determinants of Health, Genetics, Diagnostic Safety and Quality, Screening, Disparities

Chambers EC, McAuliff KE, Heller CG

Toward understanding social needs among primary care patients with uncontrolled diabetes.

This study examined the relationship between unmet social needs and diabetes among a predominantly Black and Hispanic patient population in a large urban hospital system in Bronx, New York. A total of 5846 patients with diabetes seen at a primary care visit between April 2018 and December 2019 were included and completed a social needs screener. Twenty-two percent of the patient sample had at least 1 unmet social need, with the most prevalent unmet needs being housing issues, food insecurity, and lack of healthcare transportation. Patients with more unmet needs had a greater likelihood of uncontrolled diabetes, with lack of healthcare transportation and food insecurity having the greatest likelihood.

AHRQ-funded; HS026396.

Citation: Chambers EC, McAuliff KE, Heller CG . Toward understanding social needs among primary care patients with uncontrolled diabetes. J Prim Care Community Health 2021 Jan-Dec;12:2150132720985044. doi: 10.1177/2150132720985044..

Keywords: Diabetes, Chronic Conditions, Primary Care, Vulnerable Populations, Social Determinants of Health

Patel SA, Krasnow M, Long K

Excess 30-day heart failure readmissions and mortality in black patients increases with neighborhood deprivation.

Researchers examined whether neighborhood environment modifies the disparity in 30-day heart failure (HF) readmissions and mortality between Black and White patients in the Southeastern United States. They created a geocoded retrospective cohort of patients hospitalized for acute HF from 2010-2018 within Emory Healthcare. They found that excess 30-day HF readmissions and mortality were present among Black patients in every neighborhood strata and increased with progressive neighborhood socioeconomic deprivation.

AHRQ-funded; HS026081.

Citation: Patel SA, Krasnow M, Long K . Excess 30-day heart failure readmissions and mortality in black patients increases with neighborhood deprivation. Circ Heart Fail 2020 Dec;13(12):e007947. doi: 10.1161/circheartfailure.120.007947..

Keywords: Heart Disease and Health, Cardiovascular Conditions, Hospital Readmissions, Racial and Ethnic Minorities, Mortality, Social Determinants of Health, Low-Income, Disparities

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