176 - The effect of the COVID-19 pandemic on social determinants of health

Poster Board #: 176
Publication #: 2905-HP-QA.176

Background: The COVID-19 pandemic has greatly increased rates of childhood poverty. Previous work has examined the effect of the pandemic on specific outcomes such as poverty and food insecurity, but the pandemic’s effect on the spectrum of patients’ social needs has not yet been examined. Our study uses data from a continuous, clinic-wide social determinants of health (SDH) screen to examine shifts in patients’ needs before and during the pandemic.


Objective: Assess the effect of the COVID-19 pandemic on the spectrum of social needs March – June 2020, the peak of the pandemic in NYC, compared to March – June 2019.


Design/Methods: Retrospective cohort study of caregivers of children 0-36 mo. screened for SDH at well visits using a standardized, universal screening process, in a high-continuity urban FQHC serving low-income families. Reviewing all completed SDH screens, we compared the spectrum of social needs endorsed by caretakers, Mar – Jun 2020 vs. Mar – Jun 2019. The 11-item SDH screen was adapted from the Health Leads tool, and includes the 2-item hunger vital sign. Prevalence of social needs 2020 vs. 2019 described and compared via logistic regression, controlled for child age.


Results: 224 caregivers screened Mar-Jun 2020, 426 screened Mar-Jun 2019. See table 1 for rates of social needs. Those screened in 2020 compared to 2019 were more likely to screen positive for at least one social need, have food insecurity, and respond positively to both items on the hunger vital sign. Those screened in 2020 were less likely to note needs for child care, health insurance, legal aid, and adult education; see table 2.

Conclusion(s): In this urban FQHC during the COVID-19 pandemic, caregivers reported higher rates of SDH overall and food insecurity, and reported lower rates of need for other social determinants. While it is unlikely that the pandemic reduced any hardships, a significant increase in food insecurity may have down-prioritized other needs for families. Eviction protection may have reduced need for legal aid, and work and school closures may have reduced need for child care. In 2020, fewer families presented for in-person care and for SDH screening, and those that were seen and screened may have been more likely to have social needs. Detailed measurement of SDH trends may assist health care providers, local governmental, and community organizations to optimally target social services interventions, resource allocation, and policy. Support: The United Hospital Fund/PECD consortium, NY Community Trust, NYU CTSA UL1-TR001445, HRSA T32-HP22238.


Table 1 - Rates of Social Needs, 2020 vs. 2019


Table 2 - Shift in Social Needs

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Authors/Institutions: Andrew J. Nastro, NYU School of Medicine/Bellevue Hospital Center, New York , New York, United States; Laura Ibanez Gomez, Family Health Centers at NYU Langone, Brooklyn, New York, United States; Caitlin F. Canfield, NYU School of Medicine/Bellevue Hospital Center, New York , New York, United States; Rebecca Krasnoff, NYU School of Medicine, New York, New York, United States; Iman Sharif, Harlem Hospital Center, New York, New York, United States; Arthur H. Fierman, NYU School of Medicine/Bellevue Hospital Center, New York , New York, United States; Suzy Tomopoulos, NYU School of Medicine/Bellevue Hospital Center, New York , New York, United States