Rapid-cycle community assessment of health-related social needs of children and families during COVID-19

Ray, Kristin N; Ettinger, Anna K; Dwarakanath, Namita; Mistry, Sejal V; Bey, Jamil; Chaves-Gnecco, Diego; Alston, Kaila A; Ripper, Lisa; Lavage, Daniel R; Landsittel, Douglas P; Miller, Elizabeth

OBJECTIVE: To identify unmet health and social resource needs during a county-wide COVID-19 stay-at-home order and phased re-opening in Western Pennsylvania. METHODS: With public health, social service, and community partners connected through an ongoing academic-community collaborative, we developed and fielded a weekly repeated cross-sectional electronic survey assessing usage of and unmet need for health and social service resources. Using ten weeks of surveys (April 3-June 11, 2020) by Allegheny County residents, we examined variation in responses by week and by sociodemographic characteristics using chi-square tests. We shared written reports weekly and discussed emerging trends with community partners. RESULTS: Participants ranged from 229-1,001 per week. Unmet need for at least one health or health-related social need resource varied by week, ranging from 55% (95% confidence interval (CI) 50-59%) of participants in week 2 to 43% (95% CI 37-49%) of participants in week 9 (p=0.006). Increased use of at least one resource ranged from 53% (95% CI 47-58%) of participants in week 3 to 36% (95% CI 31-42%) in week 9 (p<0.001). Unmet need for food and financial assistance peaked early during the stay-at-home order, while unmet need for mental health care rose later. Unmet need for food assistance varied significantly by race and ethnicity and by household pre-pandemic income. CONCLUSIONS: Over half of families with children reported unmet health or social service needs during the first month of a county-wide COVID-19 stay-at-home order. Unmet needs varied with race, ethnicity, and income and with duration of the stay-at-home order.