National Healthcare Quality and Disparities Report
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Topics
- Asthma (1)
- Back Health and Pain (1)
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- Provider: Health Personnel (1)
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- Research Methodologies (1)
- Respiratory Conditions (1)
- Risk (3)
- Screening (5)
- (-) Social Determinants of Health (27)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 27 Research Studies DisplayedBeidler LB, Razon N, Lang H
"More than just giving them a piece of paper": interviews with primary care on social needs referrals to community-based organizations.
The purpose of this qualitative study was to describe primary care practice’s referrals to community-based organizations. The researchers utilized semi-structured interviews with 50 healthcare administrators in charge of social care efforts within their organization. Fifty diverse United States healthcare organizations and agencies were included. The study found that social needs referrals were an essential element of administrator’s social care activities. Administrators described the optimal referral program as one which places limited burden on care teams, provides patients with customized referrals, and facilitates closed-loop referrals. The researchers identified three key challenges organizations encounter when trying to implement the optimal referrals program: 1) developing and maintaining resources lists; 2) aligning referrals with patient needs; and 3) measuring the efficacy of referrals. Administrators The study concluded that primary care practice referrals to community-based organizations were used to improve patients' social conditions, but administrators report challenges providing customized and current information to their patients.
AHRQ-funded; HS024075.
Citation: Beidler LB, Razon N, Lang H .
"More than just giving them a piece of paper": interviews with primary care on social needs referrals to community-based organizations.
J Gen Intern Med 2022 Dec;37(16):4160-67. doi: 10.1007/s11606-022-07531-3..
Keywords: Primary Care, Social Determinants of Health, Community-Based Practice, Healthcare Delivery
Stransky ML, Fuchu P, Prendergast K
Beyond housing for health: using flexible funds to improve maternal and child health.
The purpose of this article is to describe the Upstreaming Housing for Health’s (UHfH) use of a flexible fund. The UHfH was a pilot program developed and implemented to improve housing stability and decrease health inequities among people with high-risk pregnancies and their babies. The flexible fund is a cash transfer policy that served 50 families from 2019 to 2020 and addressed housing stability and material needs that encouraged family stability within the context of their housing. The researchers found that 76% of the families accessed flexible funds for items such as rental assistance, cribs, and breast pumps, with average financial support of $1343 (standard deviation = $625). The researchers advise that cash transfer policies such as the flexible fund have been shown to positively impact family health and well-being around the world.
AHRQ-funded; HS022242.
Citation: Stransky ML, Fuchu P, Prendergast K .
Beyond housing for health: using flexible funds to improve maternal and child health.
J Urban Health 2022 Dec;99(6):1027-32. doi: 10.1007/s11524-022-00686-8..
Keywords: Children/Adolescents, Behavioral Health, Social Determinants of Health, Outcomes
Burgermaster M, Rodriguez VA
Psychosocial-behavioral phenotyping: a novel precision health approach to modeling behavioral, psychological, and social determinants of health using machine learning.
The purpose of this study was to demonstrate a novel application of machine learning for psychosocial-behavioral phenotyping, which includes the identification of subgroups with similar combinations of psychosocial characteristics. The researchers conducted a secondary analysis of psychosocial and behavioral data from a community cohort (n = 5,883). The study found 20 psychosocial-behavioral phenotypes. Each phenotype suggested different contextual considerations for intervention design. The researchers concluded that psychosocial-behavioral phenotypes can identify possible targets of intervention.
AHRQ-funded; HS019853.
Citation: Burgermaster M, Rodriguez VA .
Psychosocial-behavioral phenotyping: a novel precision health approach to modeling behavioral, psychological, and social determinants of health using machine learning.
Ann Behav Med 2022 Nov 18;56(12):1258-71. doi: 10.1093/abm/kaac012..
Keywords: Social Determinants of Health, Health Information Technology (HIT), Research Methodologies
Fraze TK, Beidler LB, Savitz LA
"It's not just the right thing . . . It's a survival tactic": disentangling leaders' motivations and worries on social care.
The purpose of this study was to understand the motivations and concerns of health care organizations when implementing activities targeted at improving patients’ social conditions, such as housing, food, and economic insecurity. The researchers conducted semi-structured interviews with the administrators of 29 health care organizations to explore their issues around their agency’s provision of social care. Participants described an interconnected set of motivations for delivering social care: 1) doing the right thing for their patients, 2) improving health outcomes, and 3) business/ financial aspects. Administrators voiced uncertainty around a) responsible for social care, b) whether health care has the capacity and abilities to provide social care, and c) whether social care activities can be sustained. The researchers concluded that administrators of health care agencies and organizations could benefit from policy-maker guidance and support on how to effectively prioritize social care activities, partner with other sectors to provide social care, and develop the workforce that would be required to do so.
AHRQ-funded; HS024075.
Citation: Fraze TK, Beidler LB, Savitz LA .
"It's not just the right thing . . . It's a survival tactic": disentangling leaders' motivations and worries on social care.
Med Care Res Rev 2022 Oct;79(5):701-16. doi: 10.1177/10775587211057673..
Keywords: Social Determinants of Health, Workforce
Sonik RA, Herrera AL
Associations between inspections for unsafe housing conditions and evictions in New York City public housing buildings.
The authors sought to examine the relationship between evictions and formal housing safety inspections triggered by tenant complains about poor conditions. Studying residential buildings within New York City Housing Authority developments, they found that these buildings were in areas with greater social vulnerability than 90% of other census tracts in the state. Further, adjusted predicted probabilities of an eviction increased from 34 to 43% in the presence of a rodent inspection and from 34 to 46% in the presence of an indoor environmental inspection, indicating that inspections for unsafe housing conditions were associated with evictions at the building level.
AHRQ-funded; HS026317.
Citation: Sonik RA, Herrera AL .
Associations between inspections for unsafe housing conditions and evictions in New York City public housing buildings.
J Community Health 2022 Oct;47(5):849-52. doi: 10.1007/s10900-022-01114-3..
Keywords: Social Determinants of Health, Public Health
Guo JW, Wallace AS, Luther BL
Psychometric evaluation of the screener for intensifying community referrals for health.
The purpose of this study was to explore the Screener for Intensifying Community Referrals for Health (SINCERE) literacy screening tool. The researchers invited patients seeking care in a tertiary care emergency department (ED) to complete the SINCERE during their registration, with a total of 5,081 patients in the final sample. The study found that SINCERE’s items measure one construct, as verified through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The researchers concluded that the SINCERE is a valid and reliable instrument for measuring health and social needs.
AHRQ-funded; HS026505.
Citation: Guo JW, Wallace AS, Luther BL .
Psychometric evaluation of the screener for intensifying community referrals for health.
Eval Health Prof 2022 Sep;45(3):270-76. doi: 10.1177/01632787211029360..
Keywords: Social Determinants of Health
Rogstad TL, Gupta S, Connolly J
Social risk adjustment In the hospital readmissions reduction program: a systematic review and implications for policy.
Investigators reviewed fourteen studies of social risk adjustment in Medicare's Hospital Readmissions Reduction Program (HRRP). They concluded that their findings support the use of social risk adjustment to improve provider payment equity and highlight opportunities to enhance social risk adjustment in value-based payment programs.
AHRQ-funded; HS026727.
Citation: Rogstad TL, Gupta S, Connolly J .
Social risk adjustment In the hospital readmissions reduction program: a systematic review and implications for policy.
Health Aff 2022 Sep;41(9):1307-15. doi: 10.1377/hlthaff.2022.00614..
Keywords: Social Determinants of Health, Hospital Readmissions, Risk, Policy
Jackson P, Goodin BR, Long DL
The area deprivation index corresponds effectively with other measures of objective socioeconomic status in adults with chronic low back pain.
The purpose of this study was to compare the Area Deprivation Index (ADI) and other measures of socioeconomic status (SES), including income, education, and subjective social status (SSS), in their ability to predict pain severity/ interference in patients with chronic low back pain. The study found that pain severity/ interference correlated negatively with income and education and correlated positively with ADI. Criterion scores of the pain severity model indicate income performs best followed by ADI, with similar results with the pain interference model. The study concluded that when attempting to understand the impact of SES on chronic low back pain, neighborhood-level and individual-level factors should be considered.
AHRQ-funded; HS013852.
Citation: Jackson P, Goodin BR, Long DL .
The area deprivation index corresponds effectively with other measures of objective socioeconomic status in adults with chronic low back pain.
J Nurs Meas 2022 Sep 1;30(3):433-48. doi: 10.1891/jnm-d-20-00126..
Keywords: Back Health and Pain, Pain, Chronic Conditions, Social Determinants of Health
Fraze TK, Beidler LB, Gottlieb LM
A missed opportunity? How health care organizations engage primary care clinicians in formal social care efforts.
The purpose of this study was to explore how health care organizations include clinicians in formal social care efforts. Administrators of 29 health care organizations participated in 33 semi-structured interviews in 2019. Administrators were hesitant to increase primary care providers' responsibilities with social care activities, but believed clinicians could engage in social care programs in 4 ways: 1) Strengthen relationships with patients by discussing social risks; 2) adjust follow-up clinical care plans based on social risks; 3) adapt prescriptions based on social risks; and (4) refer patients to other care team members who can directly assist with social risks.
AHRQ-funded; HS024075.
Citation: Fraze TK, Beidler LB, Gottlieb LM .
A missed opportunity? How health care organizations engage primary care clinicians in formal social care efforts.
Popul Health Manag 2022 Aug;25(4):509-16. doi: 10.1089/pop.2021.0306..
Keywords: Primary Care, Provider: Clinician, Social Determinants of Health
Miller-Rosales C, McCloskey J, Uratsu CS
Associations between different self-reported social risks and neighborhood-level resources in Medicaid patients.
Investigators sought improved understanding of how social risk factors interact with each other and with neighborhood characteristics in order to inform efforts to reduce health disparities. They found that among 5 commonly associated social risk factors, Medicaid patients in a large Northern California health system typically reported only a single factor and that these factors did not correlate strongly with each other. They found only modestly greater social risk reported by patients in the least resourced neighborhoods. They concluded that their results suggested that individual-level interventions should be targeted to specific needs whereas community-level interventions may be similarly important across diverse neighborhoods.
AHRQ-funded; HS027343.
Citation: Miller-Rosales C, McCloskey J, Uratsu CS .
Associations between different self-reported social risks and neighborhood-level resources in Medicaid patients.
Med Care 2022 Aug;60(8):563-69. doi: 10.1097/mlr.0000000000001735..
Keywords: Medicaid, Social Determinants of Health
Leifheit KM, Schwartz GL, Pollack CE
Building health equity through housing policies: critical reflections and future directions for research.
This article provides a series of recommendations to help build health equity through housing policies. The authors recommend more justice- and action-oriented research to help address current levels of housing insecurity that are the result of clear and inequitable policy choices, leading to the entrenchment of health inequities-particularly, across race and class.
AHRQ-funded; HS000046.
Citation: Leifheit KM, Schwartz GL, Pollack CE .
Building health equity through housing policies: critical reflections and future directions for research.
J Epidemiol Community Health 2022 Aug;76(8):759-63. doi: 10.1136/jech-2021-216439.
Keywords: Social Determinants of Health, Vulnerable Populations, Policy
Kim B, Mulready-Ward C, Thorpe LE
Housing environments and asthma outcomes within population-based samples of adults and children in NYC.
This study assessed the relationship between housing type (i.e., home ownership, public housing, rental assistance, rent-controlled housing, and other rental housing) and asthma outcomes among New York City (NYC) adults and children (ages 1-13). The authors used the 2019 NYC Community Health Survey (CHS) and 2019 NYC KIDS survey to analyze associations between housing type and ever having been diagnosed with asthma (“ever asthma”) and experiencing an asthma attack within the past year. They also examined whether associations were modified by smoking status (among adults), smoking within the house (among children), and overweight/obesity. Among adults, living in public housing, compared to home ownership, was associated with higher odds of ever asthma and past-year asthma attack. Rental assistance housing living was also significantly associated with ever asthma. Public or rental assistance housing associations and ever asthma were marginally significant among children but were more pronounced among ever smokers than among never smokers.
AHRQ-funded; HS026120.
Citation: Kim B, Mulready-Ward C, Thorpe LE .
Housing environments and asthma outcomes within population-based samples of adults and children in NYC.
Prev Med 2022 Aug;161:107147. doi: 10.1016/j.ypmed.2022.107147..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Social Determinants of Health, Vulnerable Populations, Urban Health, Chronic Conditions
Blanco C, Kato EU, Aklin WM
AHRQ Author: Kato EU, Tong ST, Bierman A, Meyers D
Research to move policy - using evidence to advance health equity for substance use disorders.
This paper discusses ways that evidence-based research can advance health equity for substance use disorder (SUD) treatment. Racial and ethnic disparities in treatment access and outcomes have widened, despite substantial efforts to address the epidemic of overdose-related deaths in the US. Overdose rates are rising faster in Black, Latinx, and American Indian and Alaska Native populations than in White populations. Possible opportunities to address these disparities include addressing social determinants of health, implementing prevention measures, and supporting data science. The steps to ensure that research reduces disparities are to: 1) include members of underrepresented groups in the development of preventive interventions and treatments, 2) adequately recruit members of historically represented groups and ensure that studies are large enough to measure differences in outcomes according to race and ethnic group, 3) establish equitable partnerships with people who currently have or have had SUDS and their families and engage these groups in evidence production, 4) diversify the scientific workforce, and 4) have investigators measure the effects of policies and interventions on equity.
AHRQ-authored.
Citation: Blanco C, Kato EU, Aklin WM .
Research to move policy - using evidence to advance health equity for substance use disorders.
N Engl J Med 2022 Jun 16;386(24):2253-55. doi: 10.1056/NEJMp2202740..
Keywords: Substance Abuse, Behavioral Health, Policy, Racial and Ethnic Minorities, Disparities, Social Determinants of Health
Kostelanetz S, Pettapiece-Phillips M, Weems J
Health care professionals' perspectives on universal screening of social determinants of health: a mixed-methods study.
The purpose of this AHRQ-funded study was to assess health care providers’ perceptions of universal social determinants of health (SDH) screening. Th researchers used mixed methods of electronic surveys and qualitative interviews to assess health care providers (physicians, administrators, advanced practice providers, nurses, pharmacists, social workers, and case managers) on their perceptions of universal SDH screening at an academic medical center. The electronic survey evaluated SDH screening practices, attitudes and barriers to universal screening, priorities for SDH domains, and disciplines to perform screening. There were 193 survey participants, representing a 62.5% response rate, most of which were physicians (31%) or social workers (22%). Ninety-three percent of respondents reported using SDH information in patient care, with 95% reporting that social workers were the most appropriate for providing screening. Barriers to SDH screening which were identified included lacking the: resources to address the needs which were identified (51%); time to ask (45%); staff to ask (33%) and; training in responding to the identified needs (28%). Social worker staff reported barriers less frequently than non- social worker staff. The qualitative interview (n=16) results were utilized to elaborate the electronic survey findings and identify themes. Qualitative interview data supported the survey findings and described barriers such as lack of standardized approaches and professional burnout. The researchers concluded that health care providers support universal social determinants of health screening and recommend that strategies to address barriers to implementation should include improving SDH data access for providers and capitalize on social worker expertise.
AHRQ-funded; HS026122.
Citation: Kostelanetz S, Pettapiece-Phillips M, Weems J .
Health care professionals' perspectives on universal screening of social determinants of health: a mixed-methods study.
Popul Health Manag 2022 Jun;25(3):367-74. doi: 10.1089/pop.2021.0176..
Keywords: Social Determinants of Health, Screening, Provider: Health Personnel
McQueen A, Kreuter MW, Herrick CJ
Associations among social needs, health and healthcare utilization, and desire for navigation services among US Medicaid beneficiaries with type 2 diabetes.
The purpose of this study was to determine the number and types of social needs experienced by Medicaid beneficiaries with type 2 diabetes and how these social needs are associated with key health indicators. Findings showed that having more social needs was associated with a wide range of indicators of poor health and well-being. Study participants with the greatest social need burden were most open to intervention.
AHRQ-funded; HS019455.
Citation: McQueen A, Kreuter MW, Herrick CJ .
Associations among social needs, health and healthcare utilization, and desire for navigation services among US Medicaid beneficiaries with type 2 diabetes.
Health Soc Care Community 2022 May;30(3):1035-44. doi: 10.1111/hsc.13296..
Keywords: Diabetes, Chronic Conditions, Medicaid, Social Determinants of Health
Neiman PU, Flaherty MM, Salim A
Evaluating the complex association between social vulnerability index and trauma mortality.
Researchers merged CDC Social Vulnerability Index (SVI) data with a statewide trauma registry and employed three analytic models to evaluate the association between SVI quartile and inpatient trauma mortality. Results showed that, while higher SVI was associated with worse mortality in the unadjusted model, there was no significant association between SVI and inpatient mortality after adjusting for covariates common to trauma. Higher SVI was associated with a higher likelihood of presenting with penetrating injuries. These findings suggested that the burden of trauma mortality is not driven by variation in quality of treatment, but by lethality of injuries. The researchers concluded that improvement in trauma survival among high-risk communities will require interventions and policies which target social and structural inequities upstream of trauma center admission.
AHRQ-funded; HS028672; HS027788.
Citation: Neiman PU, Flaherty MM, Salim A .
Evaluating the complex association between social vulnerability index and trauma mortality.
J Trauma Acute Care Surg 2022 May; 92(5):821-30. doi: 10.1097/ta.0000000000003514..
Keywords: Social Determinants of Health, Trauma, Mortality
Cole MB, Nguyen KH, Byhoff E, Byhoff E
Screening for social risk at federally qualified health centers: a national study.
In the United States, millions of low-income patients have unaddressed social risks. Federally Qualified Health Centers (FQHCs) provide services to approximately 29.8 million low-income patients, and data on social risk screening capabilities had never been collected across all FQHCs until 2019. The purpose of this study was to analyze the social risk screening capabilities across the FQHCs, report the national rates, identify screening predictors, and compare rates between states. The researchers collected data from the 2019 Uniform Data System from all 1,384 FQHCs across the U.S., with a primary outcome of determining whether each FQHC collected data on their patients’ social risk factors. The researchers also estimated the relationship between the characteristics of 7 FQHCs (such as their size, and various Medicare features), and their probability of conducting social risk screening. The study reported that 71% of FQHCs collected information on social risks, with variances between states. The researchers concluded that while the majority of FQHCs collect data on social risk factors, there are disparities between different states, and that smaller FQHCs may benefit from having social risk screening resources focused on them and may increase their use of screening tools and practices.
AHRQ-funded; HS022242.
Citation: Cole MB, Nguyen KH, Byhoff E, Byhoff E .
Screening for social risk at federally qualified health centers: a national study.
Am J Prev Med 2022 May;62(5):670-78. doi: 10.1016/j.amepre.2021.11.008..
Keywords: Social Determinants of Health, Vulnerable Populations, Screening
Steeves-Reece AL, Totten AM, Broadwell KD
Social needs resource connections: a systematic review of barriers, facilitators, and evaluation.
The purpose of this mixed-studies review was to evaluate how studies assess social needs (for example, food and housing) resource connections and identifies the factors reported by patients and caregivers that that may prevent or facilitate connections to resources. The researchers developed a priori selection criteria which were used in a dual review to select PubMed and CINAHL articles published from October 2015 to December 2020. Data was analyzed in 2021. The researchers identified 34 articles from 32 studies and created a taxonomy of resource connection measures with 4 categories: 1) whether participants had contact with resources; 2) whether participants received resources; 3) whether participants had their social needs addressed; or 4) whether participants rated some aspect of their experience with resources. Barriers to resource connections included inadequacy, inaccessibility, fears surrounding stigma or discrimination, staff training, and others. Facilitators included relevancy, degree of support within the interventions, inclusivity of the interventions, and others. The authors concluded that this review study highlights variables that can be addressed to improve the screening of social needs and referral interventions.
AHRQ-funded; HS027707.
Citation: Steeves-Reece AL, Totten AM, Broadwell KD .
Social needs resource connections: a systematic review of barriers, facilitators, and evaluation.
Am J Prev Med 2022 May;62(5):e303-e15. doi: 10.1016/j.amepre.2021.12.002..
Keywords: Social Determinants of Health, Screening
Bucholz EM, Toomey SL, McCulloch CE EM, Toomey SL, McCulloch CE
Adjusting for social risk factors in pediatric quality measures: adding to the evidence base.
The purpose of this study was to evaluate a method for incorporating social risk variables into a pediatric measure of utilization from the Pediatric Quality Measures Program (PQMP). The researchers utilized data from California Medicaid claims (2015-16) and Massachusetts All Payer Claims Database (2014-2015) to assess health plan performance using the Pediatric Asthma Emergency Department Use measure. The study found that of 133 health plans serving 404,649 pediatric patients with asthma, 7% to 13% changed performance categories after social risk adjustment. Health plans that shifted to higher performance categories cared for lower socioeconomic status (SES) patients, while those that shifted to lower performance categories cared for higher SES patients. The study concluded that adjustment for social risk factors shifted performance rankings on the PQMP Pediatric Asthma Emergency Department Use measure for a large number of health plans.
AHRQ-funded; HS025297; HS025299.
Citation: Bucholz EM, Toomey SL, McCulloch CE EM, Toomey SL, McCulloch CE .
Adjusting for social risk factors in pediatric quality measures: adding to the evidence base.
Acad Pediatr 2022 Apr;22(3s):S108-s14. doi: 10.1016/j.acap.2021.09.023..
Keywords: Children/Adolescents, Quality Measures, Quality of Care, Risk, Social Determinants of Health
Vasan A, Darko O, Fortin K
Community resource connection for pediatric caregivers with unmet social needs: a qualitative study.
The authors aimed to explore caregivers' perceived barriers to and facilitators of community resource connection. Through semi-structured interviews, they identified four primary themes, including competing priorities and burdensome application processes. They recommended electronic resources to help caregivers identify locally available services, with longitudinal supports to ensure caregivers can establish and maintain linkages with these services.
AHRQ-funded; HS028555.
Citation: Vasan A, Darko O, Fortin K .
Community resource connection for pediatric caregivers with unmet social needs: a qualitative study.
Acad Pediatr 2022 Apr;22(3):461-69. doi: 10.1016/j.acap.2021.09.010..
Keywords: Children/Adolescents, Caregiving, Social Determinants of Health
Murray E, Roosevelt GE, Vogel JA
Screening for health-related social needs in the emergency department: adaptability and fidelity during the COVID-19 pandemic.
Researchers sought to evaluate a screening and referral program for health-related social needs (HRSN) in an emergency department. Using the Accountable Health Communities Screening Tool, they found that, during the COVID-19 pandemic, HRSN doubled, likely reflecting the economic impact of the pandemic.
AHRQ-funded; HS023901.
Citation: Murray E, Roosevelt GE, Vogel JA .
Screening for health-related social needs in the emergency department: adaptability and fidelity during the COVID-19 pandemic.
Am J Emerg Med 2022 Apr;54:323.e1-23.e4. doi: 10.1016/j.ajem.2021.09.071..
Keywords: COVID-19, Social Determinants of Health, Emergency Department, Screening, Public Health
de Loizaga SR, Schneider K, Beck AF
Socioeconomic impact on outcomes during the first year of life of patients with single ventricle heart disease: an analysis of the National Pediatric Cardiology Quality Improvement Collaborative Registry.
In a retrospective cohort analysis of infants enrolled in the National Pediatric Cardiology Improvement Collaborative, researchers investigated the impact of community-level deprivation on morbidity and mortality for infants with single ventricle heart disease in the first year of life. They found that community deprivation was associated with mortality and length of stay for patients with single ventricle congenital heart disease. While patients near the mean deprivation index had a higher hazard of one year mortality compared to those at the extremes of the deprivation index, length of stay and deprivation index were linearly associated, demonstrating the complex nature of socioeconomic factors.
AHRQ-funded; HS021114.
Citation: de Loizaga SR, Schneider K, Beck AF .
Socioeconomic impact on outcomes during the first year of life of patients with single ventricle heart disease: an analysis of the National Pediatric Cardiology Quality Improvement Collaborative Registry.
Pediatr Cardiol 2022 Mar;43(3):605-15. doi: 10.1007/s00246-021-02763-2..
Keywords: Children/Adolescents, Social Determinants of Health, Quality Improvement, Quality of Care, Cardiovascular Conditions, Registries, Outcomes
Hua CL, Brown JS
Childhood socioeconomic status and physical activity in later life: the role of perceived neighborhood cohesion and wealth in adulthood.
Researchers used data from the Health and Retirement Study and a structural equation modeling approach to examine whether perceived neighborhood social cohesion and adulthood wealth mediate the relationship between childhood socioeconomic status (SES) and physical activity. They found that perceived neighborhood social cohesion and adulthood wealth have small but statistically significant mediational effects in the relationship between childhood SES and physical activity.
AHRQ-funded; HS000011.
Citation: Hua CL, Brown JS .
Childhood socioeconomic status and physical activity in later life: the role of perceived neighborhood cohesion and wealth in adulthood.
J Appl Gerontol 2022 Feb;41(2):506-14. doi: 10.1177/0733464820969312..
Keywords: Children/Adolescents, Social Determinants of Health
Dennett JM, Baicker K
Medicaid, health, and the moderating role of neighborhood characteristics.
The purpose of this study was to evaluate whether the characteristics of different neighborhoods have an impact on the interaction between local environment and the effect of health insurance on health. The researchers utilized existing data from the Oregon Health Insurance Experiment and combined it with new, expanded data on neighborhood characteristics to assess whether those characteristics impacted the relationship between getting health insurance and health outcomes. The study found that the multiple domains of neighborhood characteristics did not affect the correlation between insurance and health outcomes, and concluded that Medicaid expansions do not differ greatly in effectiveness across neighborhoods.
AHRQ-funded; HS000055.
Citation: Dennett JM, Baicker K .
Medicaid, health, and the moderating role of neighborhood characteristics.
J Urban Health 2022 Feb;99(1):116-33. doi: 10.1007/s11524-021-00579-2..
Keywords: Medicaid, Social Determinants of Health, Health Insurance
Carroll AR, Hall M, Brown CM
Association of race/ethnicity and social determinants with rehospitalization for mental health conditions at acute care children's hospitals.
This retrospective cohort study evaluated the associations of race/ethnicity and social determinants with 90-day rehospitalization of children with mental health conditions to acute non-psychiatric children’s hospitals. Children included were aged 5 to 18 years at 32 freestanding U.S. children’s hospitals from 2016-2018 using the Children’s Hospital Association’s Pediatric Health Information System (PHIS) database to assess the association of race/ethnicity and social determinants (insurance payer, neighborhood median household income, and rurality of patient home location) with 90-day rehospitalization. Among 23,556 index hospitalizations, 5.9% (n = 1382) were rehospitalized for mental health within 90 days. Non-Hispanic Black children were 26% more likely to be rehospitalized than non-Hispanic White children. Those with government insurance were 18% more likely to rehospitalized than those with private insurance. Those living in a suburban location were 22% less likely to be rehospitalized than those living in an urban location.
AHRQ-funded; HS026122.
Citation: Carroll AR, Hall M, Brown CM .
Association of race/ethnicity and social determinants with rehospitalization for mental health conditions at acute care children's hospitals.
J Pediatr 2022 Jan;240:228-34.e1. doi: 10.1016/j.jpeds.2021.08.078..
Keywords: Children/Adolescents, Hospital Readmissions, Behavioral Health, Social Determinants of Health, Racial and Ethnic Minorities