January 12, 2026  – Individuals facing challenges related to housing stability, transportation, and personal safety are significantly more likely to use emergency department services, according to a new study published in JAMA Network Open. The findings of Health-Related Social Needs and Health Care Utilization in the Accountable Health Communities Model, add to growing evidence that unmet social needs play a major role in health care utilization, particularly among Medicare and Medicaid populations.

The study was conducted by researchers from Allina Health in Minnesota and examined the relationship between emergency department (ED) use and health-related social needs, often referred to as HRSNs. These needs include issues such as housing stability and quality, food insecurity, access to transportation, utility access, and interpersonal safety. Researchers analyzed data from 166,682 Medicare and Medicaid beneficiaries who were screened for HRSNs through the federal Accountable Health Communities (AHC) program between June 2018 and January 2022.

At the time of screening, nearly one in four participants, or 24.3%, were identified as having at least one unmet social need. The analysis, which was completed between June 2024 and September 2025, found clear differences in health care utilization between those with and without these needs.

Emergency department visits were notably higher among individuals reporting housing instability and transportation barriers. According to the study, 26.9% of participants with housing stability needs had an ED visit, compared with 14.3% of those without such needs. Transportation challenges were also strongly linked to ED use, with 25.6% of individuals reporting transportation needs visiting the emergency department, compared with 13.9% of those who did not report this barrier.

Safety concerns showed a similar pattern. Participants who reported interpersonal safety needs had a 27.7% prevalence of ED use in the previous six months, nearly double the rate of those without reported safety issues. The findings suggest that when individuals struggle to meet basic social needs, they may be more likely to seek care in emergency settings rather than through routine or preventive services.

The authors noted that their findings are consistent with prior research linking health-related social needs to other adverse outcomes, including delayed medication use and missed preventive visits, such as well-child appointments. These patterns, they wrote, highlight how social challenges can disrupt access to timely and appropriate care.

The study also pointed to evidence that addressing social needs may help reduce health care utilization. Researchers referenced prior work in which unhoused patients received transitional housing support at hospital discharge, followed by longer-term housing assistance. In that study, individuals who received housing services experienced 29% fewer hospitalizations and 24% fewer emergency department visits over an 18-month period compared with those who did not receive such support.

Despite the strong associations identified, the authors emphasized that further research is needed. They noted that health-related social needs can change over time, and understanding how improvements or worsening conditions affect health care use will be important for designing effective interventions.

“Further research on the fluctuation of individual HRSNs over time is warranted to better understand if resolution of needs is associated with reduced health care utilization,” the researchers concluded.

The findings add to ongoing discussions among policymakers and health systems about the role of social supports in reducing avoidable emergency care and improving overall health outcomes.