Student-run Free Clinic Research Articles

43071 Assessing the Impact of Volunteer Training at Dermatology Student-Run Free Clinic

43071 Assessing the Impact of Volunteer Training at Dermatology Student-Run Free Clinic

Abstract P190: Management Of Patients With Hypertension: Challenges From A Student-Run Free Clinic

Background/Objectives: The Anne Kastor Brooklyn Free Clinic (BFC) is a student-run free clinic affiliated with the SUNY Downstate Health Sciences University which provides healthcare to the uninsured and represents patients from all five boroughs of New York City. Through this research, we were able to identify improvements for the management and care of a prevalent condition in a community which is both disadvantaged and underserved. Methods: De-identified data on patient visits were aggregated from the electronic health record of the BFC from 2020-2022 and organized into a database using Redcap. We analyzed chief complaints, prescriptions, symptoms, comorbidities, and demographics for patients with hypertension at the BFC during this time period. Results: Our analysis included 121 patients in 311 total visits. The average blood pressure for patients with hypertension was 144/83 (stage 2 hypertension). 18.9% of patients were obese, with an average BMI of 33.1 (SD: 9.76). Most patients presented for a general check-up (67.5%) or for cardiovascular concerns (15.1%) at an in-person visit (67.8%). Patients were predominantly female (63.6%), black (38.0%), non-smokers (69.1%) with a history of diabetes (24.6%) and alcohol use (26.4%). Patients frequently had hypertension (49.6%) and type II diabetes (38.0%) within the family. Physicians noted a common physical exam finding of lower extremity edema (15.1%) and frequently ordered HbA1c (30.4%) and lipid panel (29.2%) labs. 42.2% of patients were on medications to control their hypertension, and 25.3% of visits included a prescription of antihypertensive medications. 86.5% of visits included lifestyle counseling. Most patients were scheduled for a follow-up (80.6%). Conclusion: Many patients presented with poorly-treated chronic illnesses, leading to an increase in cardiovascular complications like hypertension. A minority of patients were taking medications to control their hypertension, and fewer were prescribed antihypertensives at their visit, suggesting the need for improved pharmacologic management of hypertension in addition to lifestyle counseling. Patients should also be encouraged to present in-person to assess for pitting edema and other cardiovascular concerns.

Characteristics of Patients with Dermatologic Conditions in a Student-Run Free Clinic: A Retrospective Study

Background: The Equal Access Clinic is a free, student-run clinic affiliated with the University of Florida in Gainesville, Florida. Four days a week, a general clinic is held at various sites, providing free healthcare to patients in North Florida. Once a month, a specialty clinic for dermatology is held based on a referral system from general clinics. We aimed to characterize patients’ demographics and diagnoses who received dermatologic care at a free clinic in North Florida.
 Methods: A retrospective chart review was completed for patients seen at Equal Access Clinic for a dermatology diagnosis from 2013 to 2020 (n=864).
 Results: One third of patients were seen for a chronic dermatology condition. Patients who were white and higher earners were more likely to travel further distances for care.
 Conclusions: These findings highlight the importance of improving access of dermatology care to underserved areas and may be accomplished in part by increasing access to transportation to clinics. Limitations include the retrospective nature of our chart review and the reliance on zip code to estimate median household income. Additionally, the patients in this study were seen by primary care physicians, rather than dermatologists.

Skincare from the inside out: a pilot project addressing social determinants of health through dermatology.

Many women's shelters across the nation have programs that emphasize and empower women through career workshops and skills training. However, what is not typically addressed is their dermatological and mental health needs, which are equally important. Through this pilot project, we aim to address the diverse interrelated issues concerning the whole woman and her body/mind systems including skin cancer awareness, skincare, healthy sun habits, self-esteem, mental health, and stress management. By addressing the woman holistically, we hope to positively impact the way she views and values herself. We partnered with a local women's shelter to host a seminar focused on dermatological and mental health education. Pre- and post-seminar surveys were collected from participants. Surveys were anonymous and aimed to evaluate the success and efficiency of the workshop to guide and improve future seminars. The seminar had three workshops: skin cancer and sun protection, skincare, and mental health and wellness. Upon completion of the seminar, the attendees were provided with the opportunity to receive free skin examinations by two board-certified dermatologists, and referrals were made to Northeast Ohio Medical University's Student-Run Free Clinic. Upon completion of the seminar, attendees were provided with items such as sunscreen, skincare, and mental health resources. The "Skincare from the Inside Out" pilot project proved to be beneficial to residents of both Norma Herr Women's Shelter. Limitations of this study were the small sample size (n = 15), due to participation limitations during the COVID-19 pandemic. Ultimately, to reduce the morbidity and mortality of dermatologic conditions associated with homelessness, it is imperative to address upstream social determinants of health. Future development of this pilot project will aim toward educating medical professionals on the unique and complex dermatologic and mental health needs of women experiencing homelessness.

COVID-19 Testing and Resources for Underserved Communities in Rural Tijuana

Flying Samaritans at the University of California, Los Angeles (UCLA) is a 501(c)(3) nonprofit, undergraduate student-led organization which provides medical and dental care, prescription medications, and health education resources free-of-cost to two underserved, rural communities in Tijuana, Mexico. Free Coronavirus Disease 2019 (COVID-19) testing is not widely accessible in Tijuana. Pandemic-related job loss and high rates of financial instability in the communities create financial barriers which limit COVID-19 test accessibility. The COVID-19 Resources Project was developed to provide free, on-site COVID-19 rapid tests to patients at Flying Samaritans at UCLA’s monthly clinics. This project also offers reimbursement for the roundtrip cost of transportation to vaccination sites for patients who lack access to their own method of transportation, in order to eliminate barriers to getting vaccinated. Lastly, partnerships created with non-profit organizations funded this project and allowed for the provision of additional resources to the patient population. Details regarding this program’s development are provided in order to assist student-run free clinics which may be looking to start their own rapid testing and/or grant-funded projects. Lastly, COVID-19 testing is planned to continue into the future.

Assessing Adherence to Statin Prescription Guidelines at a Student-Run Free Clinic: A Retrospective Review.

The goals of this quality improvement project are to assess the BRIDGE Student-Run Free Clinic's adherence to the 2019 American College of Cardiology (ACC)/American Heart Association (AHA)Guideline on the Primary Prevention of Cardiovascular Disease and to compare our rate of statin prescription to the national average and to uninsured groups. A quality improvement project of 205 patients qualified by initial inclusion criteria at a student-run free healthcare clinic. Socio-demographic information, clinical measures associated with cardiovascular risk, and documentation regarding statin prescription at the follow-up visit after a patient's first lipid panel were abstracted from medical records. Descriptive statistics were calculated on the sample (proportions, means), and the proportion of patients eligible for statin treatment was determined. Of 58 patients eligible by guidelines to receive statins, 29 received a statin (50%) at their follow-up visit. Patients with clinical atherosclerotic cardiovascular disease (ASCVD) were more likely to receive statin therapy (83.3%) compared to other groups. Patients who were prescribed a statin were older, had higher total cholesterol, higher low-density lipoprotein (LDL), higher systolic blood pressure, and had higher ASCVD risk. Patients receiving statins were also more likely to be male or have a history of either hypertension, diabetes, or clinical ASCVD. Patients with established ASCVD had high rates of statin prescription.Following the first lipid panel, clinicians prescribed statins to approximately 50% of eligible patients.Although this proportion is below the national average for insured patients, it is higher than the national average for uninsured patients and represents a relatively high proportion of eligible patients within the examined time frame.

Exploring the option of student-run free health clinics to support people living with type 2 diabetes mellitus: a scoping review.

Diabetes is a major cause of morbidity and premature mortality worldwide and now identified as a 'public health emergency' and a 'modern and preventable pandemic'. Indigenous populations are disproportionately affected by type 2 diabetes mellitus (T2DM) and associated complications. Student run free clinics (SRFCs) may play an important role in the prevention and management of T2DM. The primary objective of this scoping review was to investigate the opportunity for curriculum enhancement through the role and effectiveness of SRFCs in managing T2DM. Electronic databases such as PubMed, CINAHL, Science Direct and Cochrane Library were searched from inception to October 2022. Identified records from database literature searches were imported into Covidence®. Two independent reviewers screened and extracted the data. The research team collectively created a data charting table/form to standardize data collection. A narrative synthesis was used to summarize the evidence. Six studies (total of 319 participants) that met our eligibility criteria were included in this scoping review. SRFCs can provide high-quality diabetic care, especially for uninsured and economically weaker population. Preliminary evidence further indicate that shared medical appointments and telehealth may facilitate diabetic care especially during times where access to care may be difficult (e.g., COVID lockdown). However, no study included in the review explored or discussed family centred/culturally sensitive interventions. Hence, such interventions should be made part of the curriculum in the future with students in SRFCs exposed to such an approach.

Patient Satisfaction and Healthcare Seeking at Three Free Clinics

Background: Patient satisfaction is an important metric that has been associated with social determinants of health and multiple health outcomes. However, limited studies have been conducted at free clinics, particularly comparing multiple clinics.
 Methods: This study surveyed patient satisfaction at three free clinics in Tampa, Florida. A written survey was distributed to patients at the clinics over 6 weeks.
 Results: Satisfaction was generally high among the clinics, with patients from the student-run free clinic reporting the highest satisfaction. There was no significant difference in satisfaction scores among the clinics after adjusting for socioeconomic variables. Despite high satisfaction scores, only 58.8% of patients reported coming to clinic for a general check-up, and only 20.1% reported coming for a cancer screening test.
 Conclusions: The differences between clinics were attributable to demographic factors, highlighting the importance of considering social determinants of health when discussing satisfaction. Patients at the free clinics in this sample reported high satisfaction with their care, but self-reported low receipt of preventative care. The results may indicate that patients at free clinics would benefit from education about free clinic services and what constitutes quality healthcare.

Controlling Pharmaceutical Costs in a Student-Run Free Clinic in a Resource-Limited Patient Setting.

Our institution's student-run free clinic has been able to offer medication at no out-of-pocket cost to all patients since it opened in 2004. We have employed two strategies to manage prescription drug costs while simultaneously increasing medication coverage: (1) using Patient Drug Assistance Programs (PDAPs) and (2) developing an institutional-level partnership with pharmaceutical charities for medication subsidization. In this study, we aimed to analyze the financial impact of these measures on the clinic.A query of clinic data over the past 5 years identified 299 active PDAPs, corresponding to 299 fully-subsidized prescriptions. In 2017, there were 35 active PDAPs, increasing to 52 (2018), 62 (2019), and 82 (2020) before a decline to 68 PDAPs in 2021. The company affiliated with the most PDAPs varied annually: GlaxoSmithKline (2017), Lilly (2018, 2019, 2020), and both GlaxoSmithKline and Lilly (2021). The most frequent medications were sitagliptin (2017), insulin (2018, 2019), albuterol (2017, 2018), and dulaglutide (2020, 2021).In addition, data extracted from the private company subsidization program was analyzed for the year 2021. Program membership was $10,000 for institution-wide medication subsidization for all uninsured patients in the hospital system. In total, the clinic was able to acquire 220 medications with a 96% subsidy, corresponding to a direct clinic cost of $2,101.28. Comparatively, the market value of these medications was $52,401.51.Utilization of free drug acquisition programs and partnerships with pharmaceutical charities allowed for an increase in cost-savings and medications provided. Although the process for applying for medication assistance programs is complex, these programs serve as powerful tools for providing medications that may otherwise be unavailable due to cost. Other clinics and healthcare settings with uninsured patients should consider these programs as a means to ease medication cost burden.

Expanding Access to Psychiatric Care Through Universal Depression Screening: Lessons from an Urban Student-Run Free Clinic.

The purpose of this study is to report the utility of a universal depression screening in a student-run free clinic (SRFC) to improve bridging to psychiatric care.Patients (n = 224) seen by an SRFC between April 2017 and November 2022 were screened for depression in the patient's primary language using the standardized Patient Health Questionnaire (PHQ-9). A PHQ-9 score greater or equal to 5 prompted psychiatry referral. Retrospective chart review was conducted to determine clinical characteristics and length of psychiatry follow-up.Out of 224 patients screened, 77 patients had positive depression screens and were referred to the SRFC's adjacent psychiatry clinic. Of these 77 patients, 56 patients (73%) were female, the average age was 43.7 (SD = 14.5), and the mean PHQ score was 10 (SD = 5.13). Thirty-seven patients (48%) accepted referral, while 40 (52%) declined or were lost to follow-up. There were no statistical differences in age or number of medical comorbidities between the two groups. Patients who accepted referrals were more likely to be female, as well as to have psychiatric histories, higher PHQ-9 scores, and a history of trauma. Reasons for declining and being lost to follow-up included transition to insurance, geographic relocation and deferral due to hesitancy in seeking psychiatric care.Implementation of a standardized depression screening reveals a significant rate of depressive symptoms among an urban uninsured primary care population. Universal screening may serve as a tool to improve the delivery of psychiatric care to underserved patients.

P04-015-23 Investigating Effectiveness of Online Learning of Nutrition Education to Interprofessional Students Volunteering at a Student Run Free Clinic

P04-015-23 Investigating Effectiveness of Online Learning of Nutrition Education to Interprofessional Students Volunteering at a Student Run Free Clinic

Assessing Medication Adherence at a Student-Run Free Clinic in the Midwest

Background: One of the primary barriers to medication adherence is traversing a physical distance to a pharmacy to pick-up medications. There are few studies that have examined how socioeconomic factors affect patient medication adherence in the context of student-run free clinics (SRFC). Low medication adherence leads to poorer patient outcomes, especially in patients with chronic diseases.
 Methods: This retrospective chart review aims to quantify the rate of medication adherence at this student-run free clinic using prescription pick-up rate and medication possession ratio (MPR). This study involved review of medication documentation in the electronic medical record (EMR) and charge reports of dispensed medications from the clinic’s community partner, OneWorld pharmacy. Prescriptions written for and picked up by Student Health Alliance Reaching Indigent Needy Groups (SHARING) patients between January 1, 2018, and May 31, 2020, were included for analysis. Medication adherence was calculated using MPR.
 Results: 1,396 prescriptions were written for 37 patients over the study period and 177 prescriptions (12.7%) were dispensed. The MPR for the patient population is 0.1128 (Standard Deviation (SD) = 0.36159). It took patients an average of 29.4 days (SD = 44.3) to pick-up medications after the prescription was sent.
 Discussion: At an off-campus pharmacy, SRFC patients had a low prescription pick-up rate and low medication adherence, with delayed time to prescription pick-up. Further investigations are needed to identify barriers to prescription adherence and improve adherence rates.

“Many people know nothing about us”: narrative medicine applications at a student-run free clinic

ABSTRACT Narrative medicine is an approach to healthcare that acknowledges the stories of patients’ lives both within and beyond the clinical setting. Narrative medicine has been increasingly recognized as a promising tool to support modern educational needs in health professions training, such as interprofessional practice, while enhancing quality of care. Here, we describe the development, implementation, and application of a narrative medicine program at the University of Minnesota Phillips Neighborhood Clinic. First, in a qualitative analysis of patient stories (n = 12) we identified themes regarding the value of the storytelling experience; patients’ personal journeys; and patients’ experiences in healthcare and other systems. Second, an interprofessional educational activity for student volunteers (n = 57) leveraging a patient narrative was observed to be satisfactory, significantly improve attitudes toward the underserved, and enhance quality of care from the perspectives of trainees. Together, findings from the two studies imply the potential benefits of broader incorporation of narrative medicine into interprofessional service settings, for both learners and patients.

Results of Leveraging Pharmaceutical Patient Assistance Programs to Expand Access to High Cost Medications in a Student-Run Free Clinic.

High costs make many medications inaccessible to patients in the United States. Uninsured and underinsured patients are disproportionately affected. Pharmaceutical companies offer patient assistance programs (PAPs) to lower the cost-sharing burden of expensive prescription medications for uninsured patients. PAPs are used by various clinics, particularly oncology clinics and those caring for underserved communities, to expand patients' access to medications. Prior studies describing the implementation of PAPs in student-run free clinics have demonstrated cost-savings during the first few years of using PAPs. However, there is a lack of data regarding the efficacy and cost savings of longitudinal use of PAPs across several years. This study describes the growth of PAP use at a student-run free clinic in Nashville, Tennessee over ten years, demonstrating that PAPs can be used reliably and sustainably to expand patients' access to expensive medications. From 2012 to 2021, we increased the number of medications available through PAPs from 8 to 59 and the number of patient enrollments from 20 to 232. In 2021, our PAP enrollments demonstrated potential cost savings of over $1.2million. Strategies, limitations, and future directions of PAP use are also discussed, highlighting that PAPs can be a powerful tool for free clinics in serving underserved communities.

Understanding the Primary Care Experience in a Student-Run Free Clinic

Background: Over 100 student-run free clinics (SRFCs) operate in the United States (US), typically serving uninsured populations. To date, there has been no effort to compare the patient-reported primary care experience in SRFCs to those of mainstream primary care (PC) clinics serving similar populations. In this study, we surveyed patients at Equal Access Birmingham (EAB), an SRFC, and compared our results to those from two PC clinics serving homeless-experienced clientele.
 Methods: We surveyed 60 EAB patients with the validated “Primary Care Quality-Homeless” survey. It generates an overall score and 4 subscale scores (clinician-patient Relationship, perceived inter-provider Cooperation, Accessibility/Coordination, Homeless-Specific Needs). We compared EAB’s ratings to those published for a Veterans Affairs (VA) mainstream PC (n=150) clinic and a homeless-tailored non-VA Health Care for the Homeless (HCH) program (n=195).
 Results: EAB’s ratings were similar to those of the mainstream VA clinic (p>0.4). EAB scored lower than the homeless-tailored non-VA HCH program in each subscale, though the difference did not achieve statistical significance. EAB patients most often praised the staff’s interpersonal skills. Items in which >25% of respondents gave a negative rating concerned wait times (29%), coordination of care (65%), and perceptions of provider skill (43%).
 Conclusions: Despite constrained resources, an SRFC scored comparably to a mainstream VA PC setting. SRFCs will play a continuing role in care of uninsured individuals, and while these data suggest SRFC patient experiences are mostly favorable, additional resources may be required to approximate the care experience achieved in clinics tailored for homeless persons.

Financial Impact of the Indiana University Student-Run Free Clinic.

Student-run free clinics (SRFCs) serve as an important public safety-net for un- and under-insured patients. Few studies have investigated their financial impact or return of investment to the community. The aim of this study was to estimate the financial impact of the Indiana University Student Outreach Clinic (IUSOC) using national market values of medical visits and lab services in 2021.From internal triage classification records maintained from March to December 2021, Current Procedural Terminology (CPT) codes were assigned corresponding to "New Patient," "Returning Quick or Long" and "Fast Track" visits. Total Work Relative Value Units (wRVUs) were calculated to then estimate the total monetary value for medical services. Similarly, the collection of laboratory services rendered from March to December 2021 were assigned costs using the 2021 Center for Medicare and Medicaid Services (CMS) fee schedule.There were a total of 1475 medical visits identified in this study under the triage categories of interest, with 440 New Patient visits, 1032 Returning Quick and Long visits, and 3 Fast Track visits. From the calculated total wRVUs, the estimated monetary value for medical services was $95,413.79. Additionally, there were 3633 eligible lab tests ordered; almost half of these (1523, 41.9%) were categorized as routine lab tests (CMP, BMP, CBC, lipid panel). The estimated value of lab services was $56,296.81.Our estimates reveal that the IUSOC provided nearly $150,000 worth of free healthcare to the community in 2021. Further, most patients were seen for return visits, revealing the opportunity to streamline logistics.

Creating a Women’s Health Coalition at a Student Run Free Clinic: A Model for Increasing Access to and Quality of Care

Introduction: At the beginning of 2021, the Indiana University Student Outreach Clinic (IU SOC) conducted an internal audit of cervical cytology and sexually transmitted infection (STI) screening, which showed low rates of preventive screenings and inconsistent follow-up, thereby demonstrating a need to increase reproductive healthcare access to underserved women in Indianapolis. 
 Methods: To increase access, multiple teams were created within the Women’s Health Coalition (WHC), ensuring robust education, follow-up, and other necessary coordination for patient care. Additionally, the WHC expanded to host a twice-monthly referral-based women’s health clinic that provided care for patients with various chief concerns and preventive care needs. Protocols for wet-mount microscopy and sexual assault were created based on national guidelines, and annual training were provided to all members of the WHC. Community partnerships were formed to expand resources, including ultrasounds, mammograms, and contraception services.
 Results: The IU SOC increased the prenatal and gynecological services offered over nine months through this initiative. Notably, a higher number of services were offered to patients who qualified for screenings in 2021 than in the prior four years combined, including cervical cytology (24.1% [Confidence Interval (CI) 18.6%, 29.7% vs. 4.2%] [CI 2.9%, 5.5%]), mammogram referrals (23.1% [CI 15.8%, 30.3%] vs. 2.3% [CI 1.0%, 3.6%]), and STI/human immunodeficiency virus (HIV)/Hepatitis testing (54.6% [CI 50.2%, 59.0%] vs 8.1% [CI 6.8%, 9.3%]).
 Conclusion: Given the success of the WHC, our approach may serve as a student-run model for other patient populations.

Improving Nurse Practitioner Practice Readiness in an Interprofessional Student-Run Free Clinic

Interprofessional collaboration is an integral part of modern health care. Students in health science programs, including nurse practitioner students, should have interprofessional education opportunities as part of their clinical experience. University-affiliated free clinics can offer students the opportunity to provide patient care as part of an interprofessional team. Developing strategies and best practices for robust interprofessional learning experiences for primary care nurse practitioner students can be achieved in a student-run free clinic. This report will describe the process and benefits of shared learning experiences between students in various health programs.

Evaluating the Prescribing Patterns of Antihypertensive Medications in a Student-Run Free Clinic

Background: Hypertension is one of the most widespread disease states and a high-risk factor for developing other cardiovascular diseases such as stroke and coronary disease. In the uninsured population, uncontrolled blood pressure is primarily due to limited access to healthcare. While there has been a review to assess the quality of hypertension management provided at the Building Relationships and Initiatives Dedicated to Gaining Equality (BRIDGE) Clinic, this study will evaluate the prescribing patterns of antihypertensives at the clinic and assess whether the clinic is adhering to current treatment guidelines.
 Methods: A retrospective chart review was performed for BRIDGE patients 18 years and older that were diagnosed with hypertension between 2012 and 2021. The drug classes studied included thiazide diuretics, calcium channel blockers (CCBs), angiotensin-converting-enzyme inhibitors (ACEI), and angiotensin receptor blockers (ARBs). The initial and maintenance doses were compared to Food and Drug Administration (FDA)-recommended dosing to determine if the appropriate doses were prescribed.
 Results: A total of 123 patient charts were reviewed. 54.7% of patients with Stage 1 hypertension were initially started on only one medication. For Stage 1 maintenance, 47.3% of the patients were continued on only one medication. In patients with Stage 2, 45.8 % were initially started on a combination of 2 or more medications. For Stage 2 maintenance, 79.2% of the patients were continued on a combination of 2 or more medications. Patients with Stage 1 had prescribing patterns that did not adhere to guidelines while most Stage 2 patients adhered to guidelines.
 Conclusions: The results suggest that the BRIDGE Healthcare Clinic may be prescribing antihypertensive medications that do not entirely follow the prescribing patterns recommended by the Joint National Committee (JNC) 8 guidelines, which may impact effective treatment outcomes.

204 Patients without health insurance and experiencing food insecurity are more likely to suffer from anxiety and depression–a cross-sectional study at a Milwaukee student-run free clinic

OBJECTIVES/GOALS: At the Saturday Clinic for the Uninsured (SCU), a Milwaukee student-run free clinic affiliated with the Medical College of Wisconsin, we screened patients for food insecurity and evaluated associations of food security status with nine separate social determinants of health (SDOH) needs and eight chronic medical conditions influenced by diet. METHODS/STUDY POPULATION: This cross-sectional study took place from October 2021-April 2022 at SCU, which only sees uninsured patients. We added the USDA six-item food insecurity form to the clinic’s larger SDOH survey, which screens for medication financing, housing stability, energy assistance, legal issues, educational/work opportunities, substance use, mental health, health insurance options, and dental care needs. We then completed chart review for demographic, diagnostic, lab, and medication information pertaining to obesity, hypertension, diabetes, dyslipidemia, chronic kidney disease (CKD), gastroesophageal reflux disease (GERD), anxiety, and depression. We conducted descriptive statistics on demographics and measured associations using both Kendall’s tau correlation and odds ratios from binomial regression. RESULTS/ANTICIPATED RESULTS: Of the 157 patients seen during this time, most were middle-aged (mean age = 49.4 years ± 14.5 years), female (n = 98, 62.4%), Black or African American (n = 66, 42%) and resided in Milwaukee County (n = 144, 92.9%). 22 (16%) screened as food insecure and had greater odds and positively correlated with needing resources for medication financing (OR = 7.28, I2 = 0.33), housing (OR = 129.99, I2 = 0.28), energy assistance (OR = 3.94,I2= 0.2), mental health (OR = 4.54, I2= 0.28), insurance (OR = 2.86, I2= 0.18), and dental care (OR=3.65,I2= 0.28), but not legal concerns, education/work opportunities, or substance use. Food insecure patients had higher odds and positively correlated with having anxiety (OR = 3.26,I2= 0.23) or depression (OR = 2.88,I2= 0.19), but not obesity, hypertension, diabetes, dyslipidemia, CKD, or GERD. DISCUSSION/SIGNIFICANCE: Patients without health insurance and experiencing food insecurity were more likely to have multiple SDOH needs and mental health diagnoses. Risk factors separate from food security status may explain associations with other chronic medical conditions, including uninsured status, socioeconomic status, eating behaviors, or food accessibility.