210 lines
7.1 KiB
YAML
210 lines
7.1 KiB
YAML
abstract: 'Background: Studying patients'' social needs is critical to the
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understanding of health conditions and disparities, and to inform
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strategies for improving health outcomes. Studies have shown that people
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of color, low-income families, and those with lower educational
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attainment experience greater hardships related to social needs. The
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COVID-19 pandemic represents an event that severely impacted people''s
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social needs. This pandemic was declared by the World Health
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Organization on March 11, 2020, and contributed to food and housing
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insecurity, while highlighting weaknesses in the health care system
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surrounding access to care. To combat these issues, legislators
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implemented unique policies and procedures to help alleviate worsening
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social needs throughout the pandemic, which had not previously been
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exerted to this degree. We believe that improvements related to COVID-19
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legislature and policy have positively impacted people''s social needs in
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Kansas and Missouri, United States. In particular, Wyandotte County is
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of interest as it suffers greatly from issues related to social needs
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that many of these COVID-19-related policies aimed to improve.Objective:
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The research objective of this study was to evaluate the change in
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social needs before and after the COVID-19 pandemic declaration based on
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responses to a survey from The University of Kansas Health System
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(TUKHS). We further aimed to compare the social needs of respondents
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from Wyandotte County from those of respondents in other counties in the
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Kansas City metropolitan area.Methods: Social needs survey data from
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2016 to 2022 were collected from a 12-question patient-administered
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survey distributed by TUKHS during a patient visit. This provided a
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longitudinal data set with 248,582 observations, which was narrowed down
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into a paired-response data set for 50,441 individuals who had provided
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at least one response before and after March 11, 2020. These data were
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then bucketed by county into Cass (Missouri), Clay (Missouri), Jackson
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(Missouri), Johnson (Kansas), Leavenworth (Kansas), Platte (Missouri),
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Wyandotte (Kansas), and Other counties, creating groupings with at least
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1000 responses in each category. A pre-post composite score was
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calculated for each individual by adding their coded responses (yes=1,
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no=0) across the 12 questions. The Stuart-Maxwell marginal homogeneity
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test was used to compare the pre and post composite scores across all
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counties. Additionally, McNemar tests were performed to compare
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responses before and after March 11, 2020, for each of the 12 questions
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across all counties. Finally, McNemar tests were performed for questions
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1, 7, 8, 9, and 10 for each of the bucketed counties. Significance was
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assessed at P<.05 for all tests.Results: The Stuart-Maxwell test for
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marginal homogeneity was significant (P<.001), indicating that
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respondents were overall less likely to identify an unmet social need
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after the COVID-19 pandemic. McNemar tests for individual questions
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indicated that after the COVID-19 pandemic, respondents across all
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counties were less likely to identify unmet social needs related to food
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availability (odds ratio {[}OR]=0.4073, P<.001), home utilities
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(OR=0.4538, P<.001), housing (OR=0.7143, P<.001), safety among
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cohabitants (OR=0.6148, P<.001), safety in their residential location
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(OR=0.6172, P<.001), child care (OR=0.7410, P<0.01), health care access
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(OR=0.3895, P<.001), medication adherence (OR=0.5449, P<.001), health
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care adherence (OR=0.6378, P<.001), and health care literacy (0.8729,
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P=.
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02), and were also less likely to request help with these unmet needs
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(OR=0.7368, P<.001) compared with prepandemic responses. Responses from
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individual counties were consistent with the overall results for the
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most part. Notably, no individual county demonstrated a significant
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reduction in social needs relating to a lack of
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companionship.Conclusions: Post-COVID-19 responses showed improvement
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across almost all social needs-related questions, indicating that the
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federal policy response possibly had a positive impact on social needs
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across the populations of Kansas and western Missouri. Some counties
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were impacted more than others and positive outcomes were not limited to
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urban counties. The availability of resources, safety net services,
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access to health care, and educational opportunities could play a role
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in this change. Future research should focus on improving survey
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response rates from rural counties to increase their sample size, and to
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evaluate other explanatory variables such as food pantry access,
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educational status, employment opportunities, and access to community
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resources. Government policies should be an area of focused research as
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they may affect the social needs and health of the individuals
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considered in this analysis.'
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affiliation: 'Mudaranthakam, DP (Corresponding Author), Univ Kansas, Dept Biostat
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\& Data Sci, Med Ctr, 3901 Rainbow Blvd, Kansas City, KS 66160 USA.
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Mudaranthakam, Dinesh Pal; Pepper, Sam; Alsup, Alexander, Univ Kansas, Dept Biostat
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\& Data Sci, Med Ctr, Kansas City, KS USA.
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Fortney, Tanner; Calhoun, Elizabeth, Univ Kansas, Dept Populat Hlth, Med Ctr, Kansas
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City, KS USA.
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Woodward, Jennifer, Univ Kansas, Dept Family Med \& Community Hlth, Med Ctr, Kansas
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City, KS USA.
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Sykes, Kevin, Univ Kansas, Dept Otolaryngol Head \& Neck Surg, Med Ctr, Kansas City,
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KS USA.
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Mudaranthakam, Dinesh Pal, Univ Kansas, Dept Biostat \& Data Sci, Med Ctr, 3901
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Rainbow Blvd, Kansas City, KS 66160 USA.'
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author: Mudaranthakam, Dinesh Pal and Pepper, Sam and Fortney, Tanner and Alsup, Alexander
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and Woodward, Jennifer and Sykes, Kevin and Calhoun, Elizabeth
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author-email: dmudaranthakam@kumc.edu
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author_list:
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- family: Mudaranthakam
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given: Dinesh Pal
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- family: Pepper
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given: Sam
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- family: Fortney
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given: Tanner
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- family: Alsup
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given: Alexander
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- family: Woodward
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given: Jennifer
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- family: Sykes
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given: Kevin
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- family: Calhoun
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given: Elizabeth
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da: '2023-09-28'
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doi: 10.2196/41369
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files: []
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issn: 2369-2960
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journal: JMIR PUBLIC HEALTH AND SURVEILLANCE
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keywords: 'social determinants of health; COVID-19; food assistance program; public
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health; quality of life; well-being; health disparity; health inequity;
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health policy; Kansas; social work; socioeconomic'
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keywords-plus: HEALTH; DETERMINANTS; DISPARITIES
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language: English
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number-of-cited-references: '42'
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orcid-numbers: 'Sykes, Kevin/0000-0001-9379-3406
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Alsup, Alexander/0000-0002-9487-4686
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Mudaranthakam, Dinesh Pal/0000-0001-9767-1158'
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papis_id: b4660c2beb853c47baa080556ddaa151
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ref: Mudaranthakam2023effectscovid19
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researcherid-numbers: 'Sykes, Kevin/D-5897-2013
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'
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times-cited: '0'
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title: 'The Effects of COVID-19 Pandemic Policy on Social Needs Across the State of
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Kansas and Western Missouri: Paired Survey Response Testing'
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type: Article
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unique-id: WOS:001008842600022
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usage-count-last-180-days: '0'
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usage-count-since-2013: '0'
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volume: '9'
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web-of-science-categories: Public, Environmental \& Occupational Health
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year: '2023'
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