Shortages impact 41 percent of infants, underscoring need for urgent action
Diapers are a basic hygiene necessity for infants and toddlers, and lack of consistent access significantly impacts both child health and family well-being.
A new study in which researchers integrated unmet diaper need screening and a diaper resource program into a health system found a widespread challenge among families with young children, revealing that 41 percent of babies screened in urban health centers lack consistent access to the diapers they need.
Researchers from Regenstrief Institute, Eskenazi Health and Indiana University School of Medicine analyzed data from more than 16,600 pediatric patients, aged 0 to 36 months, across nine Eskenazi Health Center Federally Qualified Health Centers. They identified health impacts linked to unmet diaper need, including higher rates of maternal depression, low birth weight and increased emergency department visits.
“Unmet diaper need is the gap between the number of diapers a child needs and the number a caregiver is able to provide,” said Regenstrief and Eskenazi Health Research Scientist Randall Grout, M.D., M.S. “That matters because infants rely on diapers to maintain good skin health and to sleep comfortably. Unmet diaper need affects not only the baby’s health, but also the overall well-being of the family. That’s why we screen for unmet diaper need: to identify families in need and connect them with diapers or other resources that can help reduce stress and support healthier outcomes.”
In the pre-visit questionnaire, where caregivers were asked if they ever felt they did not have enough diapers to change their child as often as they would like, key findings show that unmet diaper need often overlaps with other serious hardships:
- 78 percent of families experienced food insecurity.
- 65 percent reported transportation insecurity.
- 71 percent faced housing or rent payment difficulties.
- 88 percent struggled with financial insecurity overall.
Researchers found disparities in diaper need across racial, ethnic and language groups. Unmet diaper need affected 45 percent of non-Hispanic Black families, 40 percent of Hispanic families and more than 65 percent of families who preferred Haitian Creole as their primary language.
Addressing need
During the study period, health centers distributed more than 437,000 diapers through a partnership with the Indiana Diaper Bank to address immediate needs.
“This work shows what’s possible when health systems take a comprehensive view of patient well-being,” said Regenstrief Research Scientist and Chief Research and Development Officer at Eskenazi Health Christopher M. Callahan, M.D., senior author of the study. “By combining data-driven research with community partnerships, Eskenazi Health is helping families meet their most basic needs, and that support can have lasting effects on the health and development of young children.”
“At Eskenazi Health, we already had a comprehensive social drivers of health screening tool,” said Dr. Grout. The existing tool assesses for several needs, including food, transportation, housing and financial insecurity. “By adding a question about unmet diaper need into that existing structure, we were able to systematically screen thousands of families during well-child visits. Because it’s built into the electronic health record, the process runs automatically — allowing our teams to focus on connecting families to resources instead of worrying about whether screening is being completed.”
The study emphasizes that unmet diaper need is a critical pediatric health-related social need, comparable in urgency to food and housing insecurity. Integrating an unmet diaper need screening into routine pediatric visits provides an essential opportunity to connect vulnerable families to resources and improve child and family health outcomes.
The study, Implementation of Diaper Insecurity Screening, is published in the academic journal Pediatrics.
Varying phases of this study were supported by Eskenazi Health and the Indiana Department of Health (IDOH) through the Together We Will program. Eskenazi Health supported authors, and the IDOH supported diaper resource funding.
Authors and affiliations, as listed in the publication
Deanna Reinoso1,2,3, Haleigh Kampman1,4, Randall W Grout1,2,3,5, Armando Peña5,6, Daniel O Clark1,2, Christopher M Callahan1,2,3,5
1Regenstrief Center for Health Equity Research at Eskenazi Health, Indianapolis, Indiana.
2Indiana University School of Medicine, Indianapolis, Indiana.
3Eskenazi Health, Indianapolis, Indiana.
4Indiana University Fairbanks School of Public Health, Indianapolis, Indiana.
5Regenstrief Institute, Indianapolis, Indiana.
6Indiana University Department of Health and Wellness Design, School of Public Health, Bloomington, Indiana.
Randall Grout, M.D., M.S.
In addition to his role as a research scientist with the Clem McDonald Center for Biomedical Informatics at Regenstrief Institute, Randall Grout, M.D., M.S., is the Chief Health Informatics Officer at Eskenazi Health. He is also an assistant professor of pediatrics at the Indiana University School of Medicine.
Christopher M. Callahan, M.D.
In addition to his role as a research scientist with the Indiana University Center for Aging Research at Regenstrief Institute, Christopher M. Callahan, M.D., is chief research and development officer at Eskenazi Health and a professor of medicine at Indiana University School of Medicine.
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