Unmet Social Needs and Emergency Department Use in an Im/migrant Cohort at an Urban Safety Net Institution

Im/migrants are a vulnerable population who face numerous social barriers. These barriers likely contribute to unmet social needs, which may increase avoidable health care utilization such as emergency department (ED) visits. Within an im/migrant cohort at a large urban safety-net hospital (N = 1405 patients), we describe types and levels of unmet social needs, and estimate the relationship between level of unmet social needs and ED visit rates. Food insecurity was the most prevalent reported social need (30%), followed by educational needs (29%); employment needs (19%); barriers to paying for medications (18%); lack of transportation (17%); and housing insecurity (10%). After adjusting for sociodemographic factors, having ≥ 4 unmet social needs was associated with an additional 249.47 visits/1000 im/migrant patients/year (95% CI 15.95-482.99, p -value = 0.036), relative to those with no reported needs. Our findings emphasize the importance of rigorously assessing and addressing social needs within im/migrant populations, which may narrow disparities in ED use.