The Influence Of Social Determinants Of Health On Primary Caregiver Health Practices And Home Environment

PURPOSE: Explore the influence of social determinants of health (SDOH) on caregiver practices and home environment related to physical activity (PA), outdoor play, and screen time in families with typically developing (TD), Down syndrome- (DS), or autism-diagnosed children ages 2-6 years. METHODS: Primary caregivers (n = 172) of children (TD: n = 93, DS: n = 40, Autism n = 39) completed an online survey on SDOH and PA, outdoor play, and screen time practices. SDOH data were grouped into 5 constructs as defined by Healthy People 2030. Construct scores of 0-5 points were created for healthcare access and 0-2 points for economic stability, education, residential environment, and social context and support. SDOH total score (range 0-13 points) was calculated by summing up construct scores (higher scores = more favorable SDOH). Each variable was weighted equally. Descriptive statistics (e.g., mean, standard deviation, percent) and linear regression models (i.e., beta [β], 95% confidence intervals [CI]) were used to examine the survey data. RESULTS: Most caregivers were married (89.5%), non-Hispanic white (84.3%), female (76.7%), and 18-35 years old (55.2%). The overall SDOH mean score was 10.2 ± 2.5. TD group had the highest SDOH score (11 ± 2.4), followed by autism (10.1 ± 2.6), and DS (8.4 ± 1.7). In an analysis by SDOH constructs, DS scored lowest except in social context/support. Linear regression showed significant (p = <0.05) associations between SDOH constructs and caregiver practices. Total PA practice score was positively associated with residential environment (β = 5.94, 95% CI = 1.95, 9.94). Total outdoor play practice score was positively associated with income (β =9.27, 95% CI = 4.95, 13.58), education (β = 15.10, 95% CI = 6.75, 23.45), healthcare (β = 4.12, 95% CI = 2.10, 6.15), residential environment (β = 17.26, 95% CI = 12.12, 22.40), and social context/support (β = 7.62, 95% CI = 2.74, 12.50). Total screen time practice score was positively associated with residential environment (β = 6.27, 95% CI = 2.17, 10.36). CONCLUSIONS: This study highlights SDOH's influence on family health-related practices. Future research must prioritize SDOH in health interventions, particularly in exploring impacts on non-typically developing children to understand their varied impacts in this context. Recruitment for This research was supported by the UNC Intellectual and Developmental Disabilities Research Center (IDDRC), P50 HD103573. This research was supported by a grant from the T32 Cancer Health Disparities Training Grant from the National Cancer Institute of the National Institutes of Heal