To determine the prevalence of social determinants of health (SDOH) in a pediatric neurology clinic in an urban hospital to better understand how to address patients’ needs and improve health outcomes.

Studies have shown that SDOH such as food and housing insecurity impact patient health outcomes. However, the majority of these studies have been performed in general pediatric clinics, and the impact of SDOH on patients with complex medical conditions in subspecialty clinics has not been well documented. These patients are at high risk of medical complications and have high utility of emergency medical services when complications arise.

Parents or guardians of 132 children with epilepsy completed the 15-question Epilepsy Needs Assessment Survey (ENAS) regarding their child. This survey contains validated screening questions for SDOH, as well as ED usage. We also conducted a retrospective chart review for severity of epilepsy (patients’ independence in ADLs, verbal and epilepsy status).

At least one insecurity was reported by 51.1% of caregivers, with 20.3% of participants reporting 3 or more. Families with less insecurities reported less ED visits related to seizures (p < 0.001), and less missed neurology appointments (p = 0.019). We also found an increased prevalence of insecurities in patients with intractable epilepsy compared patients without intractable epilepsy (p = 0.009).

The ENAS identified ED usage and prevalence of SDOH in children with epilepsy. Results indicate that families with more insecurities are at higher risk of ED visits related to seizures and missing neurology appointments. Broader use of this screening tool would be a low-cost method to increase recognition for markers of severe epilepsy and families at highest risk of increased utilization of medical services.