93 - Racial and Ethnic Inequities in Families’ Receipt of Referrals for Unmet Social Needs in Pediatric Primary Care

Poster Number: 93
Publication Number: 93.211

Annelise Brochier, Boston Medical Center, Boston, MA, United States; Emily Messmer, Mass General Brigham, Somerville, MA, United States; Yorghos Tripodis, Boston University School of Public Health, Boston, MA, United States; Mari-Lynn Drainoni, Boston University School of Medicine, Boston, MA, United States; Arvin Garg, University of Massachusetts Medical School, Worcester, MA, United States

Background: Policy recommendations have prompted integration of social needs screening and referral systems into pediatric practice; however, little is known regarding racial/ethnic inequities in the implementation of such social care models.

Objective: To identify racial/ethnic inequities in the receipt of social needs screening and resource referrals at well-child care visits.

Design/Methods: We derived data from a cluster RCT evaluating effectiveness and implementation of a social needs screening and referral intervention (WE CARE) in 6 community health centers. WE CARE is composed of 1) a self-administered paper screener assessing the presence of 7 unmet social needs (childcare, education, employment, food, housing, language, utilities) and caregivers’ desire for help meeting those needs; and 2) EHR-based community resource information referral system. We collected WE CARE screener and referral data from EHRs of children receiving Medicaid at birth, and followed them through age 3. We conducted descriptive statistics and multiple logistic regression to compare the odds of receiving a social needs screener and appropriate resource referral across different racial and ethnic groups.

Results: Across 1219 WE CARE screeners uploaded to patients’ EHRs, respondents reported a total of 1073 needs and requested help with 946 (88%) of these needs. Of the 946 requests for help, 344 (36%) had a corresponding resource referral documented in the EHR. There were no significant race- or ethnicity-based differences in receiving a WE CARE screener; however, non-Hispanic White patients who desired help were significantly more likely to receive a clinician-generated referral to a community resource compared to other racial and ethnic groups (White 47% vs. Asian 22%, Latinx 28%, Black 39% p< .001). After adjusting for household language, child age and child sex, Hispanic patients had 0.43 times the odds (95% CI: 0.21-0.89) and Asian patients had 0.31 times the odds (95% CI: 0.13-0.77) of receiving a resource referral compared to non-Hispanic White patients.Conclusion(s): We found no racial/ethnic differences in receipt of social needs screeners and no significant differences in receipt of referrals between non-Hispanic Black and non-Hispanic White patients; however, caregivers of Asian and Hispanic patients who requested help with unmet social needs were significantly less likely to receive resource referrals compared to caregivers of non-Hispanic White patients who desired assistance. Our findings have important implications for the equitable implementation of social needs screening and referral systems into pediatric practice.