639: PREVALENCE OF ADVERSE SOCIAL DETERMINANTS OF HEALTH IN THE PEDIATRIC INTENSIVE CARE UNIT

Abstract

Introduction: Social determinants of health (SDH) such as food security, housing, transportation and education have been linked to poor health, increased risk of chronic diseases, and unnecessary emergency department visits and hospitalizations. Screening for adverse SDH is routinely performed in pediatric outpatients and demonstrates a prevalence of 20%. The aim of this study was to determine the prevalence and characteristics of adverse SDH in patients admitted in a pediatric critical care setting. We hypothesized that the prevalence would be higher than in the outpatient setting. Methods: This is a single center prospective observational study of patients admitted to the Pediatric Intensive and Intermediate Care Units at a tertiary care children’s hospital with a Level 1 Trauma Center. Families were screened using the THRIVE screen, a validated, self-administered tool that assesses social needs that impact a patient’s healthcare. The tool was translated into Spanish, Haitian Creole and Portuguese. The nursing staff distributed forms to families at the time of admission. Families who identified adverse SDH had the option to receive resources from social workers. Results: Overall, 218 families were screened during the study. Of these, 75 families (34%) reported at least 1 unmet social need; of these, 44 (59%) requested more education and 35 (47%) requested resources. Of those that reported at least one need, the median number of needs was 2 (IQR 1-3). The most common need was food (53%), followed by employment (36%), medications (24%), utilities (23%), housing (21%), transportation (17%), and caregiving (5%). Of those that requested resources, the most common requested resource was food (47%). 8 (4%) of the forms returned were in a language other than English. There were no significant differences in the number of needs among English-speaking and non-English speaking families. Conclusions: Compared to pediatric outpatients, there is a higher prevalence of families with adverse SDH in the pediatric critical care setting. Food insecurity is particularly prevalent. Identifying and addressing these needs has the potential to provide more individualized care, improve clinical outcomes, and reduce readmission rates. Future studies should correlate unmet social needs with clinical outcomes such as length of stay.