0869: Behavioral Health Outcomes and Social Determinants of Health in Children with Juvenile Arthritis Compared to Children with Diabetes and Healthy Children

Francesca Lupini¹, Eleanor Mackey², Tamar Rubinstein³, Stephanie Merwin¹ and Sangeeta Sule¹, ¹Children's National Hospital, Washington, DC, ²Children's National Hosptial, Washington, DC, ³Albert Einstein College of Medicine, White Plains, NY

Background/Purpose: Autoimmune illnesses, such as arthritis and diabetes, share some common characteristics, such as daily impact and the invisible nature, which may increase risk for adverse psychosocial outcomes. However, behavioral health outcomes may differ across different autoimmune illnesses. Identifying similarities and differences in psychosocial outcomes across autoimmune illnesses in children may help inform the need for illness-specific interventions. The current study compared behavioral health outcomes and social determinants of health in children with arthritis to children with diabetes and healthy controls.

Methods: Data were from the National Survey of Children’s Health 2016-2019. Participants were 365 children with current arthritis, 571 children with current diabetes, and 89,591 children with no chronic health conditions. Variables included: disease status, physical pain, behavioral problems, anxiety, depression, treatment for emotional/behavioral problems, food insufficiency, supportive neighborhood, safe neighborhood. Group differences were examined using Pearson chi-square tests for categorical variables and adjusted Wald tests to compare estimated means between groups.

Results: Children with arthritis or diabetes experienced significantly more physical pain, behavioral problems, anxiety, depression, and reported treatment for emotional or behavioral problems more than healthy controls. Children with arthritis had more anxiety (43.1% vs. 21.4%, p< 0.0001) and depression (32.9% vs. 17.2%, p=0.002) compared to those with diabetes. Children with arthritis missed more than 7 days of school compared to those with diabetes (41% vs. 25%, p< 0.0001) or healthy controls (vs. 5.7%, p< 0.0001). Children with arthritis experienced higher rates of food insecurity and poverty compared to those with diabetes or healthy controls.

Conclusion: High rates of adverse behavioral health outcomes in children with arthritis and diabetes suggests that interventions should be considered broadly for children with autoimmune illnesses. However, children with arthritis exhibit more adverse psychosocial outcomes and social determinants of health than children with diabetes and healthy controls, indicating a need for specific tailoring of interventions for that population.

Disclosures: F. Lupini, None; E. Mackey, None; T. Rubinstein, None; S. Merwin, None; S. Sule, None.