Determinants of unmet social needs and the role of parental mental health in families from multicultural and regional/rural communities of Australia

Determinants of unmet social needs and the role of parental mental health in families from multicultural and regional/rural communities of Australia | medRxiv /* */ /* */ <!-- <!-- /*! * yepnope1.5.4 * (c) WTFPL, GPLv2 */ (function(a,b,c){function d(a){return"[object Function]"==o.call(a)}function e(a){return"string"==typeof a}function f(){}function g(a){return!a||"loaded"==a||"complete"==a||"uninitialized"==a}function h(){var a=p.shift();q=1,a?a.t?m(function(){("c"==a.t?B.injectCss:B.injectJs)(a.s,0,a.a,a.x,a.e,1)},0):(a(),h()):q=0}function i(a,c,d,e,f,i,j){function k(b){if(!o&&g(l.readyState)&&(u.r=o=1,!q&&h(),l.onload=l.onreadystatechange=null,b)){"img"!=a&&m(function(){t.removeChild(l)},50);for(var d in y[c])y[c].hasOwnProperty(d)&&y[c][d].onload()}}var 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Schmied , Bin Jalaludin , Kenny Lawson , Siaw-Teng Liaw , Raghu Lingam , Andrew Page , View ORCID Profile Christa Lam-Cassettari , Katherine Boydell , Ping-I Lin , Ilan Katz , Ann Dadich , Shanti Raman , Rebekah Grace , Aunty Kerrie Doyle , Tom McClean , Blaise Di Mento , John Preddy , Susan Woolfenden , View ORCID Profile Valsamma Eapen doi: https://doi.org/10.1101/2025.09.03.25335048 James John 1 School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales , Sydney, NSW, Australia 2 Ingham Institute for Applied Medical Research , Liverpool, NSW, Australia 3 Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District , NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for James John Teresa Winata 1 School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales , Sydney, NSW, Australia 2 Ingham Institute for Applied Medical Research , Liverpool, NSW, Australia 4 National Disability Insurance Scheme Quality and Safeguards Commission , Parramatta, NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Si Wang 5 Research and Evaluation Group , The Salvation Army, NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Melissa Smead 6 Murrumbidgee Local Health District , NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Weng Tong Wu 1 School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales , Sydney, NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Weng Tong Wu Jane Kohlhoff 1 School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales , Sydney, NSW, Australia 7 Karitane , NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Virginia Schmied 8 School of Nursing and Midwifery, Western Sydney University , NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Bin Jalaludin 9 South Western Sydney Local Health District , NSW, Australia 10 School of Public Health and Community Medicine, Faculty of Medicine and Health, University of New South Wales , NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Kenny Lawson 11 School of Medicine, Western Sydney University , NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Siaw-Teng Liaw 12 WHO Collaborating Centre for eHealth, University of New South Wales , NSW, Australia 13 Population Child Health Research Group, School of Women’s and Children’s Health, Faculty of Medicine, University of New South Wales , NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Raghu Lingam 13 Population Child Health Research Group, School of Women’s and Children’s Health, Faculty of Medicine, University of New South Wales , NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Andrew Page 11 School of Medicine, Western Sydney University , NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Christa Lam-Cassettari 1 School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales , Sydney, NSW, Australia 2 Ingham Institute for Applied Medical Research , Liverpool, NSW, Australia 3 Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District , NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Christa Lam-Cassettari Katherine Boydell 14 Black Dog Institute , Sydney, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Ping-I Lin 1 School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales , Sydney, NSW, Australia 15 Department of Psychiatry and Behavioural Neuroscience, School of Medicine, Saint Louis University , Missouri, USA Find this author on Google Scholar Find this author on PubMed Search for this author on this site Ilan Katz 16 Social Policy Research Centre, Faculty of Arts, Design, and Architecture, University of New South Wales , NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Ann Dadich 17 School of Business, Western Sydney University , NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Shanti Raman 9 South Western Sydney Local Health District , NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Rebekah Grace 18 Transforming early Education and Child Health Research Centre, Western Sydney University , NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Aunty Kerrie Doyle 11 School of Medicine, Western Sydney University , NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Tom McClean 19 Uniting , NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Blaise Di Mento 1 School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales , Sydney, NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site John Preddy 6 Murrumbidgee Local Health District , NSW, Australia 20 Rural Clinical School, School of Clinical Medicine, University of New South Wales , NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Susan Woolfenden 21 Sydney Medical School, Faculty of Medicine and Health, University of Sydney , NSW, Australia 22 Sydney Local Health District , NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site Valsamma Eapen 1 School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales , Sydney, NSW, Australia 2 Ingham Institute for Applied Medical Research , Liverpool, NSW, Australia 3 Academic Unit of Infant, Child and Adolescent Psychiatry, South Western Sydney Local Health District , NSW, Australia Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Valsamma Eapen For correspondence: v.eapen{at}unsw.edu.au Abstract Full Text Info/History Metrics Data/Code Preview PDF Abstract Introduction Families from disadvantaged communities often experience social care needs that adversely impact access to social and healthcare services. This study aimed to explore the determinants of social care needs and the associated clinical characteristics such as parental mental health among families from multicultural and regional/rural communities of Australia. Methods This study is a secondary analysis of a randomised controlled trial conducted among parents/carers of children from culturally and linguistically diverse (CALD) communities of South Western Sydney and rural/regional communities of Murrumbidgee. The primary outcome of unmet social care needs was measured using the WE CARE survey. Binary logistic regression models were used to investigate the association between sociodemographic and clinical indicators associated with the risk of unmet needs at baseline (model 1), 6 months (model 2), and 12 months (model 3). Results Of the sample of 288 participants, 61% (n=176) reported one or more unmet needs. Findings of the regression analyses showed that clinical indicator such as parental mental distress (AOR 1.09, 95% CI 1.04, 1.16) alongside other sociodemographic factors such as CALD status (AOR 2.87, 95% CI 1.23, 6.69), lower levels parental education (AOR 5.76, 95% CI 2.21, 14.99), and marital status (AOR 2.07, 95% CI 1.01, 4.22) were associated with higher risk of unmet needs at baseline. Consistent with the baseline model, lower levels of parental education were significantly associated with two-to-three-fold higher odds of unmet needs at 6 and 12 months. Conclusion The study highlights the significant burden of unmet social needs among families from multicultural and rural/regional communities, emphasising the role of parental mental health and education levels as key contributing factors amongst other sociodemographic factors. Findings suggest the need for integrated, family-centred interventions that address both social and healthcare needs, particularly for vulnerable populations. Introduction Unmet social care needs refer to the absence of critical resources such as housing, food security, employment, and access to mental and physical healthcare [ 1 ]. These challenges are exacerbated among families from priority population groups such as those from culturally and linguistically diverse (CALD) as well as regional or rural communities, where systemic barriers and socioeconomic disparities often limit access to social and healthcare services. In Australia, multicultural families, including migrants and refugees, face unique challenges due to language barriers, cultural adaptation, and discrimination, which can hinder their ability to access services [ 2 , 3 ]. Similarly, families in regional and rural areas encounter inequity in access due to geographic location, fewer healthcare facilities, and limited employment opportunities, exacerbating their social and economic vulnerabilities [ 4 , 5 ]. Hence, addressing these unmet needs is crucial, as they are strongly linked to poorer physical and mental health outcomes, intergenerational disadvantage, and reduced quality of life. Australian health and social policies have emphasised the need for integrated, community- based approaches that address both medical and social determinants of health [ 6 – 9 ]. Despite these efforts, gaps persist in reaching high-risk populations, particularly those from the priority population groups. Existing service models often operate in silos, failing to provide comprehensive, coordinated care that addresses the multifaceted needs of families facing social disadvantage [ 10 , 11 ]. The social determinants of health (SDOH) framework provides a comprehensive approach for understanding how social, economic, and environmental factors collectively shape health outcomes. Studies have demonstrated the effectiveness of early intervention programs that address social determinants of health, leading to improved health and wellbeing and cost beneficial outcomes [ 12 , 13 ]. However, there is limited research on the specific factors and extent of unmet social needs and the interaction with parental mental health status and child developmental concerns among multicultural and regional/rural families in Australia. To address this knowledge gap, this study aimed to determine the sociodemographic, sociocultural, and clinical indicators such as child developmental concerns and parental mental health associated with unmet social needs among families from multicultural and regional/rural communities of Australia. Findings of this study will provide critical insights into the barriers these families face in accessing essential social and healthcare supports. The evidence generated will inform targeted policy reforms and the development of interventions aimed at enhancing service integration and accessibility. Further, identifying and addressing these critical social care needs is crucial for promoting social equity, improving health outcomes, and ensuring that all Australian families have the support they need to thrive, regardless of their cultural, socioeconomic, and geographic background. Methods Study design and participants Study findings are reported following the Consolidated Standards of Reporting Trials (CONSORT) guidelines [ 14 ]. This study is a secondary analysis of data from a parallel group randomised controlled trial (RCT) conducted among two priority population communities of South Western Sydney Local Health District (SWSLHD) and Murrumbidgee Local Health District (MLHD) representing predominantly multicultural/low-income and rural/regional communities, respectively. The authors confirm that all ongoing and related trials for this intervention are registered (ACTRN12621000766819). Parents/caregivers with a child aged six months to three years old attending Child and Family Health Services (CFHS) and other services providing child and family health care were recruited to participate in this study. All participants provided written informed consent. The recruitment and follow-up period of this study was between 1 August 2021 and 30 June 2023 with the recruitment commencing at the same time across both study sites. Further information on the randomisation and blinding, sample size calculation, and the intervention components are detailed in the published protocol [ 15 ]. Outcome measure - Unmet social needs Unmet social care needs in this study were assessed using the WE CARE survey, a brief and validated screening tool designed to efficiently identify the presence and extent of unmet social needs in families [ 16 ]. The survey comprises six binary (yes/no) responses related to family psychosocial needs, covering areas such as childcare, employment, homelessness, food security, education, and utilities. Additional questions were included for participants who respond affirmatively to any of the initial six items, prompting participants to indicate, on a three-point scale (yes, no, or maybe later), whether they require further assistance in addressing their unmet psychosocial needs. For the purpose of this study, the presence of unmet needs was dichotomised as no unmet needs (WE CARE score = 0) and one or more unmet needs (WE CARE score ≥ 1). Explanatory variables The clinical and health service use indicators included number of concerns reported via the Learn the Signs Act Early (LTSAE) assessment, parental mental health assessed via Kessler’s psychological distress scale (K10), and current service use (no, yes). The LTSAE is developed by the Centres for Disease Control and Prevention (CDC) [ 17 ], to monitor child’s development from 2 months to 5 years old. The assessment includes several domains of social and emotional, language/communication, cognitive, and movement/physical development. The K10 assessment is a widely used self-report questionnaire designed to measure psychological distress in individuals [ 18 ]. It comprises 10 items with ratings on a five-point scale assessing various aspects of emotional wellbeing and mental health over the past four weeks. The sociodemographic and sociocultural factors included: child’s age (in months), child’s gender (female, male), parent’s age (in years), CALD status (yes, no), highest level of education (Postgraduate/graduate diploma/ Bachelors, Advance diploma/Certificate ¾, Year 12 and/or below), marital status (Married, others – de facto/single/divorced), IRSAD quintiles (from Q1 - most disadvantaged to Q5 - the most advantaged), and treatment group (intervention, control). Statistical analysis Descriptive characteristics of the sample was computed using mean with standard deviation (SD) for continuous variables and frequency counts with percentages for categorical variables. Shapiro-Wilks test for normality and analysis of normal quantile-quantile plots were used to assess the normality of distribution. Univariate linear regression analysis was used to determine the factors independently associated with the risk of unmet needs. Pearson correlation was conducted to explore any significant correlation between the variables of interest. Primary analysis included three binary logistic regression analysis models to determine the sociodemographic, sociocultural, and clinical indicators associated with unmet social needs at baseline (model 1), 6 months (model 2), and 12 months (model 3). All analyses were undertaken in Statistical Package for the Social Sciences (SPSS) version 28 (IBM SPSS, IBM Corp., Armonk, NY, USA) Results Participant characteristics The CONSORT flowchart showing randomisation of participants along with follow-up at different time points is summarised in Figure 1 . The descriptive characteristics of the sample at baseline by unmet needs status is presented in Table 1 . Of the total sample of 288 participants, 61% (n=176) reported one or more unmet needs at baseline with the top concerns being help with food, mental health, employment, and day care. Download figure Open in new tab Figure 1. CONSORT study Flow Diagram View this table: View inline View popup Table 1. Descriptive characteristics of participants at baseline Findings of the regression analyses Findings of the univariate regression analysis ( Table 2 ) showed significant associations between clinical indicators such as parental mental health issues and number of child developmental concerns, as well as sociodemographic factors such as lower level of parental education (up to year 12) and marital status (de facto, single, or divorced) to be significantly associated with higher odds of unmet needs whereas those in the intervention group had lower odds of unmet social needs. View this table: View inline View popup Table 2. Associations between sociodemographic factors, clinical factors, and unmet social needs (unadjusted models) Consistent with the univariate regression analysis, the multivariate binary logistic regression models ( Table 3 ) showed that higher scores on parental mental health issues via K10 were associated with higher odds of unmet needs at baseline (AOR 1.09, 95% CI: 1.04, 1.16). Child developmental concerns did not retain significance in the adjusted models. Further, current service use showed no significant main effect, nor did it significantly moderate the association between K10, child developmental concerns, and unmet needs. View this table: View inline View popup Table 3. Associations between sociodemographic factors, clinical factors, and unmet social needs (adjusted models) In terms of sociodemographic and sociocultural factors, those from a CALD background had more than double the odds of unmet needs at baseline (AOR 2.87, 95% CI: 1.23, 6.69). Lower level of parental education (up to year 12) were associated with six-time higher odds of having one or more unmet needs (AOR 5.76, 95% CI: 2.21, 14.99) at baseline compared to those with tertiary level education. Compared to parents/caregivers who were married, those who were de facto, single, or divorced had double the odds of having one or more unmet needs (AOR 2.07, 95% CI: 1.01, 4.22) at baseline. Similar to model 1 (baseline), lower levels of parental education were significantly associated with two-to-three-fold higher odds of unmet needs at 6 and 12 months (models 2 and 3). On the other hand, compared to those in the control group, participants in the intervention group had lower odds of unmet needs both at baseline (AOR 0.32, 95% CI: 0.17, 0.59) and at 12 months (AOR 0.49, 95% CI: 0.27, 0.92). Current service use did not moderate the association between CALD, parental education, marital status, and unmet needs. Discussion This study aimed to identify the sociodemographic, sociocultural, and clinical indicators of unmet social needs among families from CALD and regional/rural communities in Australia. Our findings highlighted that a substantial proportion (61%) of families reported at least one unmet social need at baseline, with food insecurity, employment, and daycare needs being the most prevalent concerns. Additionally, parental mental health issues and key social and clinical risk factors such as CALD status, parental education, and marital status were found to be significantly associated with unmet needs. This underscores the urgent need for targeted, culturally sensitive, and multifaceted interventions and policies to effectively address these complex social challenges and improve the wellbeing of vulnerable families across Australia. Poor parental mental health was a critical determinant and was associated with increased risk of unmet needs. There is substantial evidence highlighting the bidirectional relationship where poor mental health can both contribute to and result from social disadvantage [ 19 , 20 ]. Parents experiencing psychological distress, including anxiety and depression, often face difficulties in fulfilling their caregiving roles effectively. Poor mental health can compromise their ability to meet their children’s basic needs, maintain stable housing, or navigate social and healthcare systems, thereby compounding existing social vulnerabilities [ 20 – 22 ]. Consequently, examining the role of parental mental health in predicting social disparities is vital for designing effective interventions. Understanding how poor mental health drives unmet social needs can inform the development of holistic, wraparound interventions that addresses both psychological wellbeing and social determinants concurrently, thereby reducing disparities and improving family outcomes over the long term. Consistent with previous research, lower parental education emerged as one of the strongest predictors of unmet social needs, with those having only up to year 12 education facing six- fold greater odds of unmet needs compared to parents with tertiary education. This highlights the critical role of education in providing families with health literacy, problem-solving, and access to services that can mitigate social vulnerabilities [ 23 ]. Further, it is well established that higher education is strongly linked to better employment opportunities and income stability, further reducing the risk of social disadvantage [ 24 ]. Consequently, policies and interventions aimed at reducing unmet social needs must prioritise addressing educational inequalities such as providing access and support to health literacy and community learning programs. By indirectly strengthening families’ resources and capacities through education, these initiatives have the potential to significantly alleviate social vulnerabilities and improve overall family outcomes [ 25 ]. We also found key sociocultural factors such as family structure and CALD status to further influence the extent to which families experience unmet social needs. Marital status was a significant factor, where parents who were single, divorced, or in de facto relationships had about twice the odds of experiencing unmet needs compared to married parents. This finding aligns with literature suggesting that single-parent and non-traditional family structures often face greater financial and social pressures, which may limit their ability to meet essential needs [ 26 – 28 ]. Notably, families from CALD backgrounds experienced nearly three times higher odds of unmet needs, reiterating the substantial barriers faced by those from CALD communities. These barriers may include language difficulties, lack of familiarity with available services, and potential discrimination, restricting access to essential supports [ 2 , 29 , 30 ]. These findings highlight the need for culturally sensitive, family-centred policies and support systems that address the specific challenges faced by diverse family structures and CALD communities to reduce social inequities and improve access to critical resources. Strengths, Limitations, Directions for future research This study has several strengths and limitations. One of the key strengths of this research is that it addresses a gap in understanding the determinants of unmet social needs in multicultural and regional/rural Australian families, populations often underrepresented in research. The use of validated measures for mental health and unmet needs enhances the reliability of findings. However, several limitations should be acknowledged. The reliance on self-reported data may introduce reporting bias or social desirability effects. Our sample, although diverse, may not fully represent all multicultural or regional/rural groups across Australia, limiting generalisability. Future studies should aim to explore specific cultural, linguistic, and geographic barriers via qualitative research in greater detail to inform more nuanced and effective interventions for multicultural and regional/rural communities. Evaluations of digital and community-based navigation models over longer periods will help clarify optimal implementation strategies and sustainability. Finally, investigating policy-level interventions addressing structural determinants, such as housing and employment policies, will be crucial to comprehensively reducing unmet social needs. Implications for Policy and Practice Our findings highlight the importance of tailored approaches to identify and address unmet social needs among vulnerable families. Policies should prioritise education as a key social determinant, integrating education and family support programs to empower parents. Mental health services should be embedded within community and social care frameworks, with culturally sensitive approaches and virtual support to meet the specific needs of CALD and rural/regional populations, respectively. Family support services must recognise individual family dynamics such as the additional challenges faced by single-parent and non-traditional families, ensuring access to flexible and affordable childcare, employment support, and food assistance. The demonstrated potential of digital screening and navigation interventions suggests that scaling such models could improve service access and reduce unmet needs, particularly when adapted for cultural and regional contexts. Conclusion Our study provides valuable insights into the key risk factors associated with the risk of unmet social needs among families from diverse CALD and regional/rural communities in Australia that often leads to inequity in access to services. The findings emphasise the complex and interconnected nature of sociodemographic, sociocultural, clinical factors that contribute to social vulnerabilities within these priority populations. It is imperative that policies and programs adopt a holistic, culturally sensitive approach that addresses social disparities and integrates mental health supports to overcome barriers to service access, in particular for culturally and linguistically diverse families. Further research and sustained investment in tailored interventions are critical to promoting equity and wellbeing for all Australian families. Data Availability Data are available upon reasonable request. Data collected for this study will be shared upon reasonable request to the corresponding author ( v.eapen{at}unsw.edu.au ) Declarations Data sharing statement Data are available upon reasonable request. Data collected for this study will be shared upon reasonable request. Human Ethics and Consent to Participate Declarations The study conforms to the principles outlined in the Declaration of Helsinki. All methods were carried out in accordance with relevant guidelines and regulations of The National Statement on Ethical Conduct in Human Research (2023). The South Western Sydney Local Health District Human Research Ethics Committee approved this study (2020/ETH01418). All participating parents have provided written informed consent prior to participation. Conflict of interest disclosure The authors declare that they have no competing interests. Funding This study was supported through the NSW Health COVID-19 Research Grants Round 2, following an independent peer-review process, and delivered in partnership with the University of New South Wales, South Western Sydney Local Health District, Murrumbidgee Local Health District, NSW Ministry of Health, Sydney Children’s Hospital Randwick, Western Sydney University, Ingham Institute for Applied Medical Research, Black Dog Institute, Uniting, and Karitane. The funding body had no role in the study design, data collection, analysis, interpretation, or in the writing of this manuscript. VE is supported by National Health and Medical Research Council (NHMRC) Investigator Grant #2033610 Author Contribution Conceptualisation: VE, JP, and SW; Data curation: JJ, TW, SW, and MS; Methodology and Formal analysis: JJ and TW; Funding acquisition: VE, JP, SW, JK, VS, BJ, KL, S-TL, RL, AP, KB, P-IL, IK, AD, SR, RG, AKD, and TM; Project administration: TW, SW, and MS; Writing. – original draft: JJ and TW; Writing – review & editing: All authors. Footnotes Trial registration: This trial was registered with the Australian New Zealand Clinical Trials Registry (registration number: ACTRN12621000766819). References 1. ↵ Garg A , Marino M , Vikani AR , Solomon BS . Addressing families’ unmet social needs within pediatric primary care: the health leads model . Clinical pediatrics . 2012 ; 51 ( 12 ): 1191 – 3 . OpenUrl CrossRef PubMed 2. ↵ Khatri RB , Assefa Y . 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Share Determinants of unmet social needs and the role of parental mental health in families from multicultural and regional/rural communities of Australia James John , Teresa Winata , Si Wang , Melissa Smead , Weng Tong Wu , Jane Kohlhoff , Virginia Schmied , Bin Jalaludin , Kenny Lawson , Siaw-Teng Liaw , Raghu Lingam , Andrew Page , Christa Lam-Cassettari , Katherine Boydell , Ping-I Lin , Ilan Katz , Ann Dadich , Shanti Raman , Rebekah Grace , Aunty Kerrie Doyle , Tom McClean , Blaise Di Mento , John Preddy , Susan Woolfenden , Valsamma Eapen medRxiv 2025.09.03.25335048; doi: https://doi.org/10.1101/2025.09.03.25335048 Share This Article: Copy Citation Tools Determinants of unmet social needs and the role of parental mental health in families from multicultural and regional/rural communities of Australia James John , Teresa Winata , Si Wang , Melissa Smead , Weng Tong Wu , Jane Kohlhoff , Virginia Schmied , Bin Jalaludin , Kenny Lawson , Siaw-Teng Liaw , Raghu Lingam , Andrew Page , Christa Lam-Cassettari , Katherine Boydell , Ping-I Lin , Ilan Katz , Ann Dadich , Shanti Raman , Rebekah Grace , Aunty Kerrie Doyle , Tom McClean , Blaise Di Mento , John Preddy , Susan Woolfenden , Valsamma Eapen medRxiv 2025.09.03.25335048; doi: https://doi.org/10.1101/2025.09.03.25335048 Citation Manager Formats BibTeX Bookends EasyBib EndNote (tagged) EndNote 8 (xml) Medlars Mendeley Papers RefWorks Tagged Ref Manager RIS Zotero Tweet Widget Facebook Like Google Plus One Subject Area Health Systems and Quality Improvement Subject Areas All Articles Addiction Medicine (568) Allergy and Immunology (863) Anesthesia (300) Cardiovascular Medicine (4435) Dentistry and Oral Medicine (444) Dermatology (382) Emergency Medicine (608) Endocrinology (including Diabetes Mellitus and Metabolic Disease) (1509) Epidemiology (15228) Forensic Medicine (30) Gastroenterology (1124) Genetic and Genomic Medicine (6598) Geriatric Medicine (668) Health Economics (997) Health Informatics (4536) Health Policy (1368) Health Systems and Quality Improvement (1613) Hematology (540) HIV/AIDS (1264) Infectious Diseases (except HIV/AIDS) (15916) Intensive Care and Critical Care Medicine (1103) Medical Education (623) Medical Ethics (146) Nephrology (667) Neurology (6599) Nursing (346) Nutrition (998) Obstetrics and Gynecology (1144) Occupational and Environmental Health (957) Oncology (3332) Ophthalmology (974) Orthopedics (369) Otolaryngology (420) Pain Medicine (436) Palliative Medicine (130) Pathology (663) Pediatrics (1693) Pharmacology and Therapeutics (691) Primary Care Research (711) Psychiatry and Clinical Psychology (5447) Public and Global Health (9230) Radiology and Imaging (2198) Rehabilitation Medicine and Physical Therapy (1370) Respiratory Medicine (1196) Rheumatology (593) Sexual and Reproductive Health (712) Sports Medicine (530) Surgery (712) Toxicology (99) Transplantation (289) Urology (265) (function(){function c(){var b=a.contentDocument||a.contentWindow.document;if(b){var d=b.createElement('script');d.innerHTML="window.__CF$cv$params={r:'a004e4ad38c5c13d',t:'MTc3OTU0ODAzOQ=='};var a=document.createElement('script');a.src='/cdn-cgi/challenge-platform/scripts/jsd/main.js';document.getElementsByTagName('head')[0].appendChild(a);";b.getElementsByTagName('head')[0].appendChild(d)}}if(document.body){var a=document.createElement('iframe');a.height=1;a.width=1;a.style.position='absolute';a.style.top=0;a.style.left=0;a.style.border='none';a.style.visibility='hidden';document.body.appendChild(a);if('loading'!==document.readyState)c();else if(window.addEventListener)document.addEventListener('DOMContentLoaded',c);else{var e=document.onreadystatechange||function(){};document.onreadystatechange=function(b){e(b);'loading'!==document.readyState&&(document.onreadystatechange=e,c())}}}})();