Abstract 13643: Examining the Association Between Social Determinants of Health and Health-Related Quality of Life Among Children With Cardiac Conditions

Abstract

Introduction: Patient-reported outcomes like health-related quality of life (HRQOL) measure the health and well-being of patients, providing insights not communicated by traditional outcomes. The degree to which social determinants of health (SDOH) influence HRQOL is under-studied. Methods: A cross-sectional analysis of subjects aged 8-18 years referred for cardiac catheterization from 1/1/18-12/31/21 was performed, evaluating the association between HRQOL (measured through child and caregiver-proxy reports of cardiac-specific HRQOL (Pediatric Cardiac Quality of Life Inventory (PCQLI)) and general HRQOL (Pediatric Quality of Life Inventory (PedsQL))) and a panel of potential SDOH. Potential SDOH measures were calculated at subject’s neighborhood level by linking their addresses to block group/census tract data. SDOH measures included Childhood Opportunity Index, which measures neighborhood resources supporting child development, and Social Deprivation Index, which measures neighborhoods’ levels of disadvantage. Linear regression was used to evaluate the association between SDOH and HRQOL (PCQLI and PedsQL total scores), adjusting for presence of cardiac symptoms (New York Heart Association Class). Results: In total, 111 subjects (age 12.8±2.9 years, of which 89% identified as White, 5% Black, and 8% Hispanic, and 27% Medicaid-insured) were studied. Primary cardiac diagnoses included single ventricle heart disease (19%), complex biventricular repairs (20%), and orthotopic heart transplantation (12%). The majority (69%) denied having symptoms. Out of a potential 100, subject-reported scores were 67±18 on the PCQLI and 74±19 on the PedsQL. Caregiver-proxy reported scores were 70±17 on the PCQLI and 71±19 on the PedsQL. Worse SDOH was consistently associated with lower HRQOL adjusted for presence of symptoms (Table 1). Conclusions: Worse SDOH was associated with worse HRQOL in pediatric cardiac patients independent of symptoms severity