Developmental Disabilities Are Associated with Higher Unmet Social Needs in Children.

Abstract

To compare the likelihood of self-reporting at least one health-related social need (HRSN) for pediatric patients with developmental disabilities (DD) compared with pediatric primary care (PC) patients. This cross-sectional study was conducted in a large urban health system in the Bronx, New York, between May 2023 and August 2024. We identified a cohort of patients ≤21 years old with DD (n = 1420), at an urban center that specializes in serving children with DD, who completed a standardized HRSN screener to assess housing insecurity, housing quality, utility needs, food insecurity, health care transportation needs, health care cost needs, child or adult care needs, and legal needs. We also identified a cohort of pediatric PC patients who completed the HRSN screener at 1 of 14 outpatient PC practices (n = 32 143). We completed a retrospective analysis using electronic health record data. Multivariable logistic regressions were conducted to estimate the likelihood of self-reporting at least 1 HRSN in regard to a patient's DD status, while adjusting for sociodemographic characteristics. Approximately 30.0% (n = 426) of DD patients self-reported at least 1 HRSN compared with 12.6% (n = 4064) of PC patients. In the multivariable analysis, DD patients demonstrated 2.49 (2.20, 2.82) greater odds of having at least 1 HRSN compared with PC patients. Health systems should consider developing workflows that identify and address HRSNs for pediatric patients with DD. Further research is needed to understand the factors contributing to the increased HRSN prevalence observed in patients with DD.