Social Connectedness as a Social Determinant of Health in Low Income Families with Young Children

Context Social connectedness (SC) is an important social determinant of health (SDoH) associated with decreased mortality, improved mental health, and increased self-efficacy in adults and adolescents. Social isolation in families with young children has been linked to increased child abuse, and low-income families may be at higher risk of experiencing social isolation. More research is needed to understand the role of SC as a SDoH in low-income families with young children.

Objective To examine SC in a low-income population using validated tools. To explore the role of SC as a SDoH for families with young children.

Study Design This cross-sectional analysis utilized data from the Healthy Children and Families (HCF) program. HCF is a cohort intervention study conducted by an urban pediatric clinic serving low-income families with the primary objective of addressing food insecurity.

Setting or Dataset 27 families enrolled in HCF completed the baseline Social Provisions Scale five question short form (SPS- 5) and other validated baseline assessments.

Population Studied This study included families with at least one child 0-5 years who expressed food insecurity or at-risk for food insecurity during screening.

Intervention/Instrument The SPS-5 is a validated tool used to evaluate SC. Other study instruments are divided into nutritional, child health, and parental health tools. Nutritional tools include food security status (USDA US Household Food Security Survey) and child/parental nutritional status (ASA-24 Dietary Assessment). Child health tools include body mass index (percentile for age) and developmental or behavioral diagnosis (ICD-10). Parental tools include parental stress (Parental Stress Index), parental mental health (BRFSS health perception), and financial health.

Outcome Measures Outcome measures are the correlation coefficients between social connectedness and each study outcome determined by Pearson correlations.

Results The average SPS-5 composite score 14.5 on a scale of 5-20. Strong correlations were identified between SC and parental stress and parental mental health. Moderate correlations were identified between SC and food insecurity total score, financial health, and childhood BMI.

Conclusions Social connectedness is an important social determinant of health in low-income families with young children. This study identifies questions that may be a benefit to include in pediatric health screenings. Small sample size is a limitation.