Youth and young adults (YYA) with type 1 diabetes (T1D) may be at risk for unmet social needs and depression due to the disease-associated cost and stressors. Little is known about how unmet social needs are linked to depressive symptomatology. These cross-sectional analyses used data from the SEARCH Food Security ancillary study (2018-2020) to examine the association of unmet social needs on depressive symptoms among 685 YYA with T1D. The USDA Household Food Security Survey Module was used to measure household food insecurity (HFI) over the past 12 months (food insecure (≥3 affirmations) vs. food secure). Participants were queried about their primary mode of transportation (personal vehicle vs. other form of transportation) and if they had stable housing (all the time vs. some or none of the time) over the past 90 days. Total number of unmet social needs (0-3) were calculated by summing these items. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression (CES-D) scale (scores 0-60). Linear regression was used to examine the association between number of unmet social needs and depressive symptom scores. Among YYA with T1D (mean age 23.4, SD 4.6 years), 17.1% had HFI, 14.0% lacked adequate transportation, and 4.3% experienced unstable housing; 23.5% had one, 5.1% had two, and 0.9% had three unmet social needs. Mean (SD) CES-D score was 14.3 (11.9), which is below the cutoff score of 16 for risk of depression. Compared to YYA with no unmet social needs, those with 1 and 2-3 unmet social needs had depressive symptom scores 5.9 and 15.9 points higher, respectively (p<0.0001 for both exposure values), after adjusting for age, sex, race/ethnicity, diabetes duration, clinic site, parental education, and household income. Social needs among YYA with T1D are confluent and are jointly and cumulatively associated with depressive symptoms. Future studies should investigate the impact of alleviating unmet social needs on depressive symptomatology among YYA with T1D.


A. D. Brown: None. S. M. Marcovina: None. A. D. Liese: None. J. A. Mendoza: None. E. A. Frongillo: None. K. Flory: None. B. A. Reboussin: None. E. T. Jensen: None. L. M. Dolan: None. A. Bellatorre: None. F. Malik: None.


National Institutes of Health (R01DK117461, T32GM081740)

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