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Social disparities among youth and the impact on their health

Authors Kreatsoulas C, Hassan A, Subramanian S, Fleegler E

Received 26 March 2014

Accepted for publication 26 August 2014

Published 26 March 2015 Volume 2015:6 Pages 37—45

DOI https://doi.org/10.2147/AHMT.S64903

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Steven Youngentob

Catherine Kreatsoulas,1,* Areej Hassan,2,* SV Subramanian,1 Eric W Fleegler3

1Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA; 2Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital Boston, Boston, MA, USA; 3Division of Emergency Medicine, Boston Children's Hospital Boston, Boston, MA, USA

*These authors contributed equally to this work


Purpose: Social disparities among youth have been recognized as an important influence on disease risk later in the life cycle. Despite this, social problems are seldom assessed in a clinical setting. The primary objective of our study was to evaluate the impact of social disparities on the health of youth.
Methods: A self-directed, web-based screening system was used to identify social disparities along seven social domains. Participants included youth, aged 15–24 years, recruited from an urban hospital clinic. The main outcome variable, self-rated health, was captured on a 5-point Likert scale. Univariable and multivariable regression models adjusted for sex, age, and race/ethnicity were implemented to assess the association between social problems and self-rated health. Correlation between social disparity problems was estimated using phi coefficient.
Results: Among 383 participants, 297 (78%) reported at least one social problem. The correlation among social disparity problems was low. Social disparities had an independent effect on self-rated health, and, in a fully adjusted model, disparities in health care access and food insecurity remained significant. The presence of even one social problem was associated with a decrease in overall health (β=0.68, P<0.01).
Conclusion: There is a high burden of social disparities among our youth urban hospital population. The presence of even one social problem increases the risk of worsening self-rated health. Evaluating the social disparities among youth in the medical setting can help elucidate factors that negatively affect patients' health.

Keywords: social determinants of health, self-rated health, social problems, clinical setting

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