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医疗补助受益人的社会需求和与健康相关的结果。

Social Needs and Health-Related Outcomes Among Medicaid Beneficiaries.

机构信息

1 Washington University in St. Louis, St. Louis, MO, USA.

2 Envolve PeopleCare, Farmington, CT, USA.

出版信息

Health Educ Behav. 2019 Jun;46(3):436-444. doi: 10.1177/1090198118822724. Epub 2019 Jan 17.

Abstract

Unmet social needs-including food, housing, and utilities-have been associated with negative health outcomes, but most prior research has examined the health associations with a single unmet need or analyzed samples that were homogeneous along one or more dimensions (e.g., older adults or patients with chronic health conditions). We examined the association between unmet social needs and psychosocial and health-related outcomes in a sample of Medicaid beneficiaries from 35 U.S. states. In 2016-2017, 1,214 people completed an online survey about social needs, demographics, and health-related and psychosocial outcomes. Seven items assessing social needs formed an index in which higher scores indicated higher levels of unmet needs. Participants were eligible if they were ≥18 years and had Medicaid. The sample was predominantly female (87%). Most (71%) lived with at least one child ≤18 years, and 49% were White and 33% were African American. Average age was 36 years ( SD = 13). The most common unmet needs were not enough money for unexpected expenses (54%) and not enough space in the home (25%). Analyses controlling for recruitment method and demographics showed that increasing levels of unmet social needs were positively associated with stress, smoking, and number of chronic conditions, and negatively associated with future orientation, attitudes toward prevention, days of exercise/week, servings of fruits or vegetables/day, and self-rated health (all p < .01). Results add to the evidence about the relationship between unmet social needs and health. Interventions to help meet social needs may help low-income people improve both their economic situations and their health.

摘要

未满足的社会需求-包括食物、住房和公用事业-与健康状况不佳有关,但大多数先前的研究都只考察了单一未满足需求与健康之间的关联,或者分析了沿着一个或多个维度同质的样本(例如,老年人或患有慢性健康状况的患者)。我们在美国 35 个州的医疗补助受益人样本中研究了未满足的社会需求与心理社会和健康相关结果之间的关联。在 2016-2017 年,有 1214 人完成了一项关于社会需求、人口统计学以及与健康相关和心理社会结果的在线调查。有七个项目评估社会需求,形成了一个指数,得分越高表示未满足的需求程度越高。如果符合以下条件,则参与者有资格参加:年龄≥18 岁,有医疗补助。该样本主要为女性(87%)。大多数(71%)人与至少一名≤18 岁的孩子同住,49%为白人,33%为非裔美国人。平均年龄为 36 岁(标准差=13)。最常见的未满足需求是没有足够的钱来应对意外开支(54%)和家里没有足够的空间(25%)。在控制招募方法和人口统计学特征的分析中,未满足的社会需求水平越高,与压力、吸烟和慢性疾病数量呈正相关,与未来取向、预防态度、每周运动天数、水果或蔬菜的份数/天以及自我评估健康呈负相关(均 p<.01)。结果增加了关于未满足的社会需求与健康之间关系的证据。帮助满足社会需求的干预措施可能有助于改善低收入人群的经济状况和健康状况。

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