Prevalence and Correlates of Families’ Unmet Social Needs in Pediatric Primary Care Settings

Background/Objectives: Children of families facing unmet social needs experience higher rates of adverse outcomes compared to those not experiencing unmet social needs. This study aimed to identify factors associated with families’ unmet social needs as reported by parents or guardians at their children’s primary care visits. Methods: This cross-sectional study recruited English-speaking primary caregivers of children less than 18 years of age from the Southwestern Ohio Ambulatory Research Network (SOAR-Net) who were surveyed between January 2023 and August 2024. Surveys included the Maternal Social Support Index, Social Capital Scale, RAND Depression Screener, Children with Special Health Care Needs Screener, Medical Expenses of Children Survey, a 10-item social needs screener, and demographics. Data were analyzed with chi-square or Fisher’s exact tests, adjusted logistic regression, and ANOVA. Results: Among 1167 respondents (78% response rate), 1114 provided complete data. Primary caregivers were predominantly mothers (79.9%) or fathers (13.6%), White (72.0%) or Black (16.0%), and had an associate’s degree or less (65.1%). The mean (SD) index child’s age was 6.4 (5.3) years, and 52.4% were female. Underinsurance, positive depression screens, and poor child health were positively associated with unmet social needs. Higher scores for social support and social capital were associated with fewer social needs. Multinomial logistic regression revealed significant relationships with reporting two or more unmet social needs with the following variables: childhood underinsurance, household annual income < $50,000, positive depression screens, raising a child with a chronic health condition, and Black race/ethnicity. Conclusions: Several significant social factors were independently associated with a greater number of unmet social needs. These findings highlight the complex interplay among social factors in children’s healthcare. Future research should explore the putative longitudinal stability of these relationships.