176 - The Association of Social Determinants of Health Screening with Developmental and Social-Emotional Outcomes in Children Enrolled in Head Start

Publication Number: 176.6714

Elizabeth Farkouh, Mayo Clinic Alix School of Medicine, Rochester, MN, United States; Brian a. Lynch, Mayo Clinic Children's Center, Rochester, MN, United States; Loren Toussaint, Luther College, Decorah, IA, United States

Background: The appropriate acquisition of social- and emotional- based skills in early childhood allows children to build solid relationships and develop self-regulation. These skills are associated with school-based achievement, better adult physical health, higher adult income, and decreased criminality. Various domains of social determinants of health (SDOH), defined by the WHO as “the non-medical factors that influence health outcomes,” could differentially impact child developmental and social-emotional outcomes.

Objective: This study aimed to determine whether scores on the Environmental Screening Questionnaire (ESQ), a newly developed SDOH screening tool, are associated with child developmental and social-emotional outcomes as determined by Brigance and Ages & Stages Questionnaires®-Social-Emotional (ASQ:SE-2) assessments, respectively.

Design/Methods: De-identified data from children enrolled in a Head Start Program in Northeast Iowa were collected during the 2021-2022 and 2022-2023 school years. The associations between scores in each ESQ domain (Education-Employment, Housing, Child/Family Health, Economics, Family Life and Community) and both Brigance and ASQ:SE-2 scores at the time of child enrollment into Head Start were assessed.

Results: Parent-reported concerns with Education and Employment on the ESQ were associated with reduced Brigance scores (r= -0.18, p=0.007, see Table 1). Concerns related to housing, child and family health, or the community were associated with higher (more concerning) ASQ:SE-2 scores (r=0.17, p=0.011; r=0.25, p<.001; and r=0.27, p<.001, respectively, see Table 1). In multivariable models controlling for sex, race and income, only child and family health (B = .85, Beta = .23, p = .001) and community concerns (B = 1.13, Beta = .22, p = .003) were significant predictors of ASQ:SE-2 scores. Other ESQ domains were not significantly predictive of Brigance or ASQ:SE-2 scores.

Conclusion(s): The SDOH domains of child and family health as well as community on the ESQ may be particularly important for appropriate child socio-emotional development. However, not all SDOH domains appear to be equally relevant for child developmental or socio-emotional outcomes. Knowing this, intervention efforts might focus on addressing critical SDOH domains to promote child resilience and counteract the non-medical factors that can interfere with optimal child developmental and socio-emotional outcomes. Research that examines the association of ESQ scores with child health outcomes in other settings and samples is also needed.

Table 1
Table 1.pdfTable 1. Pearson Correlations Between ESQ Concerns and Brigance and ASQ:SE-2 scores