Identify Social Determinants of Health Related to Ambulatory Care Sensitive Conditions: Decreasing Hospitalizations and Emergency Department Visits

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Maria Gjini
Nasim Khan
Gjovana Vuljaj
Adriana Stefanovski
Abbey Kaminski
Brooke Weber
Caress Dean


potentially avoidable hospitalizations, social needs, health inequalities


Introduction: Ambulatory care sensitive conditions (ACSCs) have been linked to higher emergency room and hospitalization rates. Research suggests social determinants of health (SDOH) may play a role; however, there is a limited understanding of the relationship between ACSCs and SDOH. This study's objective was to examine the relationship between structural and intermediary SDOH and chronic ACSC status among United States adults (U.S.).

Methods: Data were drawn from the 2017 Behavioral Risk Surveillance System for 12 states and U.S. territories that completed the SDOH module (N= 111,828). Descriptive statistics and binary logistic regression analysis identified SDOH associated with a chronic ACSC status.

Results: More than 45% of participants had a chronic ACSC. Individuals with ACSCs had higher odds of reporting their neighborhood as unsafe (AOR=1.25; 95%CI=1.05-1.49) than those who reported their neighborhood as extremely safe. Similarly, participants with ACSCs were significantly more likely to report challenges paying their utilities/rent/mortgage (AOR=1.18; 95%CI=1.03-1.36) than to report not experiencing challenges. 

Conclusions: To address chronic ACSCs, intersectoral public policies are warranted to diminish educational inequalities and racial disparities. This population would also benefit from community-based interventions that connect them to local resources that reduce stress and improve their financial stability and neighborhood safety level.

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