Determinants of unmet social needs and the role of parental mental health in families from multicultural and regional/rural communities of Australia

Introduction: Families from disadvantaged communities often experience social care needs that adversely impact access to social and healthcare services. This study aimed to explore the determinants of social care needs and the associated clinical characteristics such as parental mental health among families from multicultural and regional/rural communities of Australia. Methods: This study is a secondary analysis of a randomised controlled trial conducted among parents/carers of children from culturally and linguistically diverse (CALD) communities of South Western Sydney and rural/regional communities of Murrumbidgee. The primary outcome of unmet social care needs was measured using the WE CARE survey. As the data were overdispersed (variance-to-mean ratio = 2.06), multivariable and generalised estimating equations (GEE) negative binomial regression models were applied to examine factors associated with unmet needs, with unmet needs treated as count outcomes. Results: Of the sample of 288 participants, 61% (n = 176) reported one or more unmet needs. Findings of the multivariable negative binomial regression analyses showed that clinical indicators such as parental mental distress (AIRR 1.05, 95% CI 1.04, 1.07) and child developmental concerns (AIRR 1.28, 95% CI 1.12, 1.45) alongside other sociodemographic factors such as CALD status (AIRR 1.63, 95% CI 1.13, 2.35), lower levels parental education (AIRR 2.25, 95% CI 1.62, 3.15), and marital status – De facto/single/divorced (AIRR 1.42, 95% CI 1.06, 1.89) were associated with higher rate of unmet needs at baseline. Additionally, findings of the GEE negative binomial model were largely consistent with the multivariable analyses and further demonstrated that families in the intervention group had a significantly lower rate of unmet needs over time compared with the control group (AIRR 0.75, 95% CI 0.60, 0.95). Conclusion: The study highlights the significant burden of unmet social needs among families from multicultural and rural/regional communities, emphasising the role of parental mental health and education levels as key contributing factors amongst other sociodemographic factors. Findings suggest the need for integrated, family-centred interventions that address both social and healthcare needs, particularly for vulnerable populations. Trial registration: This trial was registered with the Australian New Zealand Clinical Trials Registry (registration number: ACTRN12621000766819).