P3C117: Evaluation of Social Determinants of Health and Mental Health in Pediatric Patients with Vision-threatening Diseases

Background: Social determinants of health are underrecognized in their contribution to ophthalmic outcomes. We sought to identify how they impact pediatric patients due to their increased vulnerability secondary to reliance on social structures and caregivers. Low vision has been shown to correlate with an increase in mental health symptoms; however, few studies have been performed in the pediatric population. We sought to understand the correlation of social determinants of health with specific VTDs in children, and the effect of VTDs on the mental health of patients.

Methods: We performed a cross-sectional survey of mental health symptoms using CATS, CES-DC, GAD-7, and PHQ-9A as well as assessment of social determinants of health using the CMS AHC HRSN Screening Tool in pediatric patients who presented to one of five ophthalmology clinics at a tertiary care center.

Results: We found that lower levels of vision correlated (p <.05) indirectly with age and directly with number of visits. There were also significant findings between having a diagnosis of retinopathy of prematurity (ROP) and having more non-ophthalmic diagnoses as well as between non-ophthalmic diagnoses and financial strain (p <.01). We found that 44% of participants under 11 reported having a medical event that was potentially traumatic for them, and symptoms of depression increased with age in children under 11. Though the trend did not continue in children ages 11 to 17, 13-year-olds had a higher prevalence of anxiety and depression.

Conclusion: Further work needs to be done within this sphere to properly evaluate the effect of VTDs on families and access to medical care. Children with VTDs may benefit from screening interventions to identify mental health diagnoses that may impact their quality of life.