The Interaction between Social Determinants of Health, Health Behaviors, and a Child’s Intellectual and Developmental Diagnoses

ABSTRACT Introduction Social determinants of health (SDOH) may impact a caregiver’s ability to implement evidence-based health practices at home during early childhood, especially in families with children with intellectual and developmental disabilities (IDD). This study examined the influence of SDOH and children’s diagnoses (typically developing (TD), Down syndrome (DS), or autism) on caregivers’ self-reports of meeting evidence-based health practices. Methods Caregivers ( n = 172) of children aged 2–6 yr (TD, n = 93; DS, n = 40; autism, n = 39) completed an online survey on SDOH and health practices related to child nutrition, physical activity (PA), outdoor play, and screen time. A total SDOH score was computed by assigning one point for each favorable SDOH metric (range 0–13). Linear regressions were used to examine associations between SDOH and child nutrition, PA, outdoor play, and screen time health practices and the moderating effect of IDD diagnosis. Results Most caregivers were non-Hispanic White (84.3%), female (76.7%), 18–35 yr old (55.2%), and married (89.5%). The DS group had the lowest SDOH scores (mean, 8.4 ± 1.0) compared to autism (mean, 10.1 ± 1.0) and TD (mean, 11.0 ± 0.9). No family scored 100% in evidence-based practices for any health practice. SDOH score was significantly associated with evidence-based practices met score for child nutrition ( b = 1.94; 95% confidence interval (CI), 0.84–3.04; P = 0.001) and PA ( b = 4.86; 95% CI, 2.92–6.79; P < 0.0001). Moderation analyses showed no association in the DS and autism groups between SDOH score and child nutrition percent total score and between SDOH score and child nutrition, PA, and outdoor play for percent evidence-based practices met. SDOH score was also not associated with outdoor play percent total score for the DS group. Conclusions This study highlights the differential influence of SDOH on caregivers implementing health practices in families with children with different IDD diagnoses. Future research is needed to understand the impacts of SDOH on nontypically developing children.