wow-inequalities/02-data/intermediate/wos_sample/a0d9de538c63f8969011ee91c0f2dbf3-mudaranthakam-dines/info.yaml

abstract: 'Background: Studying patients'' social needs is critical to the

  understanding of health conditions and disparities, and to inform

  strategies for improving health outcomes. Studies have shown that people

  of color, low-income families, and those with lower educational

  attainment experience greater hardships related to social needs. The

  COVID-19 pandemic represents an event that severely impacted people''s

  social needs. This pandemic was declared by the World Health

  Organization on March 11, 2020, and contributed to food and housing

  insecurity, while highlighting weaknesses in the health care system

  surrounding access to care. To combat these issues, legislators

  implemented unique policies and procedures to help alleviate worsening

  social needs throughout the pandemic, which had not previously been

  exerted to this degree. We believe that improvements related to COVID-19

  legislature and policy have positively impacted people''s social needs in

  Kansas and Missouri, United States. In particular, Wyandotte County is

  of interest as it suffers greatly from issues related to social needs

  that many of these COVID-19-related policies aimed to improve.Objective:

  The research objective of this study was to evaluate the change in

  social needs before and after the COVID-19 pandemic declaration based on

  responses to a survey from The University of Kansas Health System

  (TUKHS). We further aimed to compare the social needs of respondents

  from Wyandotte County from those of respondents in other counties in the

  Kansas City metropolitan area.Methods: Social needs survey data from

  2016 to 2022 were collected from a 12-question patient-administered

  survey distributed by TUKHS during a patient visit. This provided a

  longitudinal data set with 248,582 observations, which was narrowed down

  into a paired-response data set for 50,441 individuals who had provided

  at least one response before and after March 11, 2020. These data were

  then bucketed by county into Cass (Missouri), Clay (Missouri), Jackson

  (Missouri), Johnson (Kansas), Leavenworth (Kansas), Platte (Missouri),

  Wyandotte (Kansas), and Other counties, creating groupings with at least

  1000 responses in each category. A pre-post composite score was

  calculated for each individual by adding their coded responses (yes=1,

  no=0) across the 12 questions. The Stuart-Maxwell marginal homogeneity

  test was used to compare the pre and post composite scores across all

  counties. Additionally, McNemar tests were performed to compare

  responses before and after March 11, 2020, for each of the 12 questions

  across all counties. Finally, McNemar tests were performed for questions

  1, 7, 8, 9, and 10 for each of the bucketed counties. Significance was

  assessed at P<.05 for all tests.Results: The Stuart-Maxwell test for

  marginal homogeneity was significant (P<.001), indicating that

  respondents were overall less likely to identify an unmet social need

  after the COVID-19 pandemic. McNemar tests for individual questions

  indicated that after the COVID-19 pandemic, respondents across all

  counties were less likely to identify unmet social needs related to food

  availability (odds ratio {[}OR]=0.4073, P<.001), home utilities

  (OR=0.4538, P<.001), housing (OR=0.7143, P<.001), safety among

  cohabitants (OR=0.6148, P<.001), safety in their residential location

  (OR=0.6172, P<.001), child care (OR=0.7410, P<0.01), health care access

  (OR=0.3895, P<.001), medication adherence (OR=0.5449, P<.001), health

  care adherence (OR=0.6378, P<.001), and health care literacy (0.8729,

  P=.

  02), and were also less likely to request help with these unmet needs

  (OR=0.7368, P<.001) compared with prepandemic responses. Responses from

  individual counties were consistent with the overall results for the

  most part. Notably, no individual county demonstrated a significant

  reduction in social needs relating to a lack of

  companionship.Conclusions: Post-COVID-19 responses showed improvement

  across almost all social needs-related questions, indicating that the

  federal policy response possibly had a positive impact on social needs

  across the populations of Kansas and western Missouri. Some counties

  were impacted more than others and positive outcomes were not limited to

  urban counties. The availability of resources, safety net services,

  access to health care, and educational opportunities could play a role

  in this change. Future research should focus on improving survey

  response rates from rural counties to increase their sample size, and to

  evaluate other explanatory variables such as food pantry access,

  educational status, employment opportunities, and access to community

  resources. Government policies should be an area of focused research as

  they may affect the social needs and health of the individuals

  considered in this analysis.'
affiliation: 'Mudaranthakam, DP (Corresponding Author), Univ Kansas, Dept Biostat
  \& Data Sci, Med Ctr, 3901 Rainbow Blvd, Kansas City, KS 66160 USA.

  Mudaranthakam, Dinesh Pal; Pepper, Sam; Alsup, Alexander, Univ Kansas, Dept Biostat
  \& Data Sci, Med Ctr, Kansas City, KS USA.

  Fortney, Tanner; Calhoun, Elizabeth, Univ Kansas, Dept Populat Hlth, Med Ctr, Kansas
  City, KS USA.

  Woodward, Jennifer, Univ Kansas, Dept Family Med \& Community Hlth, Med Ctr, Kansas
  City, KS USA.

  Sykes, Kevin, Univ Kansas, Dept Otolaryngol Head \& Neck Surg, Med Ctr, Kansas City,
  KS USA.

  Mudaranthakam, Dinesh Pal, Univ Kansas, Dept Biostat \& Data Sci, Med Ctr, 3901
  Rainbow Blvd, Kansas City, KS 66160 USA.'
author: Mudaranthakam, Dinesh Pal and Pepper, Sam and Fortney, Tanner and Alsup, Alexander
  and Woodward, Jennifer and Sykes, Kevin and Calhoun, Elizabeth
author-email: dmudaranthakam@kumc.edu
author_list:
- family: Mudaranthakam
  given: Dinesh Pal
- family: Pepper
  given: Sam
- family: Fortney
  given: Tanner
- family: Alsup
  given: Alexander
- family: Woodward
  given: Jennifer
- family: Sykes
  given: Kevin
- family: Calhoun
  given: Elizabeth
da: '2023-09-28'
doi: 10.2196/41369
files: []
issn: 2369-2960
journal: JMIR PUBLIC HEALTH AND SURVEILLANCE
keywords: 'social determinants of health; COVID-19; food assistance program; public

  health; quality of life; well-being; health disparity; health inequity;

  health policy; Kansas; social work; socioeconomic'
keywords-plus: HEALTH; DETERMINANTS; DISPARITIES
language: English
number-of-cited-references: '42'
orcid-numbers: 'Sykes, Kevin/0000-0001-9379-3406

  Alsup, Alexander/0000-0002-9487-4686

  Mudaranthakam, Dinesh Pal/0000-0001-9767-1158'
papis_id: b4660c2beb853c47baa080556ddaa151
ref: Mudaranthakam2023effectscovid19
researcherid-numbers: 'Sykes, Kevin/D-5897-2013

  '
times-cited: '0'
title: 'The Effects of COVID-19 Pandemic Policy on Social Needs Across the State of
  Kansas and Western Missouri: Paired Survey Response Testing'
type: article
unique-id: WOS:001008842600022
usage-count-last-180-days: '0'
usage-count-since-2013: '0'
volume: '9'
web-of-science-categories: Public, Environmental \& Occupational Health
year: '2023'