1 For instance, there is evidence that patients with unmet social needs have higher rates of chronic conditions such as depression and diabetes, are twice as likely to frequently use the emergency department for care, and are more likely to miss scheduled office visits. This is particularly true in low‐income populations, where a recent survey estimates that over 90 percent of persons below 138 percent of the federal poverty level (FPL) have some unmet social needs. Over the last two decades, the critical link between unmet social needs, such as food insecurity, housing instability, and financial stress, and adverse health outcomes has become increasingly clear. Compared to those with no reported unmet needs, having 4+ unmet needs was significantly associated with reduced probability of having a yearly check‐up (65 percent vs 78 percent, adjusted difference = −7.1 percentage points (PP)), receiving a flu vaccine (33 percent vs 42 percent, adjusted difference = −5.4 PP), having a personal doctor (74 percent vs 80 percent, adjusted difference = −3.1 PP), and having a foot (63 percent vs 80 percent, adjusted difference = −12.8 PP) or eye examination (61 percent vs 73 percent, adjusted difference = −12.6 PP) for diabetic patients, and increased probability of being unable to see a doctor due to cost (44 percent vs 9 percent, adjusted difference = 27.9 PP) and having diabetes affect the eyes (22 percent vs 19 percent, adjusted difference = 8.0 PP) at α = 0.05. After adjusting for observable characteristics, higher levels of unmet social need were associated with poorer access and quality. Most common unmet social needs included not having enough money for balanced meals (33 percent) or food (32 percent).
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