327 Assessing socioeconomic barriers to mental health service utilization among older adults in Puerto Rico’s federally qualified health centers

Abstract

Objectives/Goals: To evaluate the impact of social determinants of health (SDOH), specifically socioeconomic status and medical insurance coverage, on access to mental health services for adults aged 60 and older served by Federally Qualified Health Centers (FQHCs) in Puerto Rico. Methods/Study Population: A secondary retrospective analysis of electronic health records from FQHCs in Puerto Rico will be conducted to examine the relationship between SDOH needs and mental health service utilization among adults aged 60 years and older receiving primary care. SDOH data will be collected using the PRAPARE® tool, assessing factors such as socioeconomic status, insurance coverage, and emotional support, with a focus on identifying unmet needs. Multivariable and logistic regression models, using Stata v.17, will be employed to evaluate correlations between these SDOH factors and mental health service utilization, adjusting for age, gender, and mental health conditions. This analysis aims to quantify the impact of SDOH on access to mental health services and elucidate key barriers to care for older adults in Puerto Rico. Results/Anticipated Results: We anticipate that lower socioeconomic status, lack of supplemental insurance, and inadequate family support will be strongly associated with the underutilization of mental health services among older adults in Puerto Rico. These disparities are expected to be more pronounced in individuals with limited income, weaker family networks, leading to significant gaps in access to necessary mental health care. Barriers such as healthcare insecurity, financial hardship, and fragmented support systems will likely emerge as major obstacles. By including patients from both rural and urban regions, the study will capture the distinct challenges each population faces, enhancing the contextual relevance of the findings to broader populations, ultimately informing policy and developing intervention strategies. Discussion/Significance of Impact: The findings will provide crucial insights for developing targeted interventions to enhance mental health care access for older adults in Puerto Rico. These results will inform policy development and public health strategies, addressing disparities and promoting equitable care in underserved populations.