408 - Social Services and Limited English Proficiency: Improving Pediatric Access to Primary and Preventive Health Care

Publication Number: 408.6689

Abraham Gallegos, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States; Paul J.. Chung, Kaiser Permanente Bernard J. Tyson School of Medicine, Los Angeles, CA, United States; Norma Perez, AltaMed Health Services, Los Angeles, CA, United States; Robert Nocon, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States

Background: Childhood poverty and related social drivers of health are linked to significant short- and long-term health risks. While socioeconomic risk factors for poor health outcomes have been widely studied, fewer studies have explored the health benefits when children access social services. Social services are vital in addressing underlying social needs, particularly for underserved populations.

Objective: This study aims to explore the association between receiving social services and primary care healthcare utilization outcomes in pediatric patients served by Federally Qualified Health Centers (FQHCs), with a focus on the role of Limited English Proficiency (LEP) in modifying these effects.

Design/Methods: A cross-sectional study was conducted using data from the 2022 Health Center Patient Survey, a nationally representative sample of patients served by FQHCs. Our outcome variables measured healthcare utilization over the previous year and included (1) having a pediatric primary care visit, (2) number of medical visits, (3) emergency room visit, and (4) having a dental exam. Our primary exposure variable was receipt of any social services (e.g., food assistance, housing support). Other independent variables included: LEP, household income above 138% of the Federal Poverty Level (FPL), age, race/ethnicity and insurance status. We used multivariable logistic and ordered logistic regression models to assess the associations between receiving social services and our four health outcomes. We used interaction terms between social services and LEP to understand how LEP modifies the relationships between receiving social services and our outcomes.

Results: The sample included 523 children, 64.31% of the weighted sample received social services. After adjusting for covariates, the interaction between social services and LEP was significantly associated with higher odds of having regular primary care (OR: 5.96, p=0.033) and dental exam visit in the year (OR: 7.68, p=0.019). Additionally, ordinal logistic regression demonstrated that this interaction was associated with an increased number of medical visits (OR: 3.82, p=0.039). However, the interaction was not significantly associated with ER visits (OR: 1.22, p=0.843).

Conclusion(s): Our findings suggest that receipt of social services, particularly among children with LEP, is associated with increased engagement in preventive health services, including primary care, medical visits, and dental exams. These results highlight the interconnectedness of language barriers, social services, and receipt of primary healthcare services.

Table 1: Weighted Distribution of Social Services Use by Demographic Variables in Pediatric Sample (N=523, Weighted Population Size: 8,793,322)


Table 2: Multivariable and Ordered Logistic Regression Results for Healthcare Utilization Outcomes
Note: *p < 0.05, **p < 0.01. Primary Care, Dental Exam, and ER Visit models use logistic regression; Number of Medical Visits model uses ordered logistic regression.