Preventive medicine reports · 2026
Changes in health-related social needs and in depression and anxiety symptoms in Massachusetts low-income, community health center patients: an observational cohort study.
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Wu Yingfei, Cheng Jessica, McCurley Jessica L, Levy Douglas E, Fung Vicki, Clark Cheryl R, Thorndike Anne N
Аннотация
OBJECTIVE: This observational cohort study examined relationships between changes in health-related social needs (HRSN) and mental health symptoms.
METHODS: A prospective cohort of adult community health center patients in Boston, Massachusetts completed surveys at baseline and 3-year follow up (LiveWell study, 2020-2024). Changes in HRSNs were categorized as decreased, unchanged, or increased based on the cumulative change in three domains: food insecurity, housing instability, and financial stress. Primary outcomes were changes in depression (Patient Health Questionnaire-8) and anxiety (Generalized Anxiety Disorder-7) scores, modeled as a function of HRSN change group and controlling for baseline scores, age, gender, and household minors using separate linear regressions.
RESULTS: Median age of the cohort (n = 821) was 42.9 (IQR 32.9-53.1) years and 77.8% were female. At follow-up, 32.6% had decreased, 43.4% had unchanged, and 24.0% had increased HRSN. Compared to the unchanged HRSN group, the decreased HRSN group had decreased depression (adjusted coefficient [aCoef] -1.3 [95%CI: -2.1, -0.5]) and anxiety scores (aCoef -0.9 [95%CI: -1.7, -0.1]); the increased HRSN group had increased depression (aCoef 3.0 [95%CI: 2.1, 3.9]) and anxiety scores (2.8 [95%CI: 2.0, 3.7]).
CONCLUSIONS: HRSN changes corresponded with changes in depression and anxiety symptoms. Interventions addressing HRSNs may help improve mental health.
METHODS: A prospective cohort of adult community health center patients in Boston, Massachusetts completed surveys at baseline and 3-year follow up (LiveWell study, 2020-2024). Changes in HRSNs were categorized as decreased, unchanged, or increased based on the cumulative change in three domains: food insecurity, housing instability, and financial stress. Primary outcomes were changes in depression (Patient Health Questionnaire-8) and anxiety (Generalized Anxiety Disorder-7) scores, modeled as a function of HRSN change group and controlling for baseline scores, age, gender, and household minors using separate linear regressions.
RESULTS: Median age of the cohort (n = 821) was 42.9 (IQR 32.9-53.1) years and 77.8% were female. At follow-up, 32.6% had decreased, 43.4% had unchanged, and 24.0% had increased HRSN. Compared to the unchanged HRSN group, the decreased HRSN group had decreased depression (adjusted coefficient [aCoef] -1.3 [95%CI: -2.1, -0.5]) and anxiety scores (aCoef -0.9 [95%CI: -1.7, -0.1]); the increased HRSN group had increased depression (aCoef 3.0 [95%CI: 2.1, 3.9]) and anxiety scores (2.8 [95%CI: 2.0, 3.7]).
CONCLUSIONS: HRSN changes corresponded with changes in depression and anxiety symptoms. Interventions addressing HRSNs may help improve mental health.