LATEBREAKER
Social
Associations between social needs and healthcare access: Findings from the 2022 BRFSS social determinants and health equity module J’Neka Claxton* J’Neka Claxton Guixiang Zhao Machell Town
Background: Access to health services is important to promoting health through the prevention and management of diseases. We aim to understand the associations between the burden of unmet social needs and healthcare access among US adults.
Methods: We used the 2022 Behavioral Risk Factor Surveillance System–Social Determinants and Health Equity module data, which were collected by 39 states, DC, and 2 US territories. A social needs summary measure was created by summing unmet social needs including questions that assessed life satisfaction, social and emotional support, social isolation, employment stability, food security, housing security, transportation access, and stress. Measures of healthcare access included no health insurance, no personal healthcare provider, inability to afford a doctor when needed, and a routine checkup 2 or more years ago. Cox regression with a robust variance estimator was used to estimate prevalence ratios, adjusting for sociodemographic variables.
Results: 257,758 respondents were eligible for inclusion. 43% of adults had zero unmet social needs. In adjusted analyses, an increase in the number of unmet social needs was associated with increased prevalence of no health insurance, no personal healthcare provider, inability to afford a doctor when needed, and a routine checkup 2 or more years ago. The largest magnitude in estimates of unmet social needs compared to zero unmet social needs occurred for the inability to afford a doctor when needed. Adults who reported 1, 2, 3, 4, and 5+ unmet social needs had 1.94, 3.18, 4.71, 6.46, 9.11 increased prevalence when compared to those who reported 0 unmet social needs. The adjusted estimates for the other outcomes were smaller in magnitude, but still statistically significant (Table).
Discussion: Incremental increases in the number of unmet social needs were independently associated with increased prevalence rates for each measure of healthcare access.
