Social Risk Factors of Pediatric Diabetes Patients in Primary Care: Associations From an Urban Health System
Kiana Bess, Rajvi Shah, Glenda Asencio, Mallika Mathur, Ashley Gibson, Shreela Sharma, Sandra McKayObjective
We examined the association between social risk factors and diabetes diagnosis from a diverse patient population in the Southern United States.
Methods
We conducted a cross-sectional analysis of children ages 0-18 who completed a social risk screener during well-child visits within a large clinical system in the Greater Houston area between September 2022 and December 2024. The screener assessed food insecurity, financial risk, transportation insecurity, and housing insecurity. Multivariable logistic regression examined the associations between social risk factors and diabetes diagnosis.
Results
The sample included 15,186 patients, of whom 59 were diagnosed with Type 1 or Type 2 diabetes and completed a social risk screener. Mean age was 6.24 years, 51.6% were male and 72.6% were publicly insured. Among patients with diabetes, 27.1% reported ≥ 2 unmet social risk factors. Food insecurity was most common and children from food-insecure households had 2.2 times higher odds of having diabetes than those from food-secure households, after adjustment.
Conclusion
Although housing and financial risk trended towards a positive association, food insecurity was the only social risk factor significantly associated with pediatric diabetes. These findings add to evidence that social conditions shape and highlight the importance of social risk informed diabetes care management.