Socioeconomic Factors and Pediatric Injury

Trinidad, Stephen; Kotagal, Meera

doi:10.1007/s40719-023-00251-x

Cited by 15 publications

(5 citation statements)

References 64 publications

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“…19 A 2023 study on SES related to pediatric injury found that the most deprived quintile had half the number of SRIs compared with more advantaged groups. 20 Using insurance status as a surrogate for SES, our study differs in that a majority of SRIs occurred in patients with government or public health insurance, whereas private insurance was less common.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Sports-Related Injuries Presenting to a Pediatric Emergency Department

Nichols,

Shah,

Jones

et al. 2023

Southern Medical Journal

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Objective: Pediatric injuries associated with participation in sports are common. Understanding the epidemiology and trends of sports-related injuries is an important component of injury prevention efforts and is the objective of this study.Methods: A retrospective review of sports injuries presenting during the course of 1 year (2019) to the emergency department (ED) of Benjamin Russell Hospital for Children, a large academic children's hospital, was performed. Inclusion criteria focused on patients 18 years old and younger whose ED visit resulted from active participation in a sport. Cases were identified using International Classification of Diseases, Tenth Revision codes. Demographic data were collected and included sex, age, race, injury specifics (sport, location, type, and mechanism). Descriptive statistics were performed and categorical variables were analyzed using the χ 2 test.Results: A total of 1333 injuries seen by the ED during 2019 were sports injuries. Most commonly, these injuries were associated with football (43%), basketball (36%), soccer (11%), or baseball (8%). Considering sports-related injuries, 428 (32%) patients were 12 years and younger and 905 (68%) were 12 years old and older. The median age was 13 years (interquartile range 4 years). Other demographic findings included male sex 1143/1333 (86%) and Black race 835/1333 (63%). School was the most common location for sports injuries (28%). When comparing injuries by age groups (younger than 12 vs 12 and older), football and baseball injuries were more common in those younger than 12 years (53% vs 38%, z = 5.2, P < 0.00001; and 14.0% vs. 5.6%, z = 4.9, P < 0.00001, respectively), whereas basketball and soccer injuries were more common in those 12 years and older (43% vs 22%, z = 7.4, P < 0.00001; and 11.4% vs 9.3%, z = 5.9, P < 0.00001, respectively). When comparing injuries by sex, football and baseball injuries were more common in males (49% vs 6%, z = 11.1, P < 0.00001; and 9.4% vs. 2.1%, z = 3.3, P < 0.00001, respectively), whereas basketball and soccer injuries were more common in females (59% vs 32%, z = 7.2, P < 0.00001; and 27% vs 8%, z = 7.8, P < 0.00001, respectively Conclusions: Sports injuries that are commonly encountered in the ED differ in age and sex. Basketball and soccer injuries were more likely to be encountered in older females, whereas baseball and football injuries were more likely seen in younger males. This may reflect efforts that have been previously focused on the sports considered to be higher risk, especially for concussive injuries. This information can help guide future preventive efforts provided by primary physicians, schools, and coaches.

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Section: Discussionmentioning

confidence: 99%

Characteristics of Sports-Related Injuries Presenting to a Pediatric Emergency Department

Nichols,

Shah,

Jones

et al. 2023

Southern Medical Journal

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“…The need to exclude the parental employment variable contrasts with findings in the literature indicating that SES has an impact on a child’s ability to recover from injury and post-injury therapy [ 62 ]. Lower family income has been associated with a higher percentage of pediatric TBI mortality [ 63 ] and higher levels of emotional difficulties and conduct problems at 12 months post-injury [ 64 ].…”

Section: Discussionmentioning

confidence: 99%

A Multidimensional Approach to Assessing Factors Impacting Health-Related Quality of Life after Pediatric Traumatic Brain Injury

Steinbüechel

Krenz

Bockhop

et al. 2023

JCM

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In the field of pediatric traumatic brain injury (TBI), relationships between pre-injury and injury-related characteristics and post-TBI outcomes (functional recovery, post-concussion depression, anxiety) and their impact on disease-specific health-related quality of life (HRQoL) are under-investigated. Here, a multidimensional conceptual model was tested using a structural equation model (SEM). The final SEM evaluates the associations between these four latent variables. We retrospectively investigated 152 children (8–12 years) and 148 adolescents (13–17 years) after TBI at the recruiting clinics or online. The final SEM displayed a fair goodness-of-fit (SRMR = 0.09, RMSEA = 0.08 with 90% CI [0.068, 0.085], GFI = 0.87, CFI = 0.83), explaining 39% of the variance across the four latent variables and 45% of the variance in HRQoL in particular. The relationships between pre-injury and post-injury outcomes and between post-injury outcomes and TBI-specific HRQoL were moderately strong. Especially, pre-injury characteristics (children’s age, sensory, cognitive, or physical impairments, neurological and chronic diseases, and parental education) may aggravate post-injury outcomes, which in turn may influence TBI-specific HRQoL negatively. Thus, the SEM comprises potential risk factors for developing negative post-injury outcomes, impacting TBI-specific HRQoL. Our findings may assist healthcare providers and parents in the management, therapy, rehabilitation, and care of pediatric individuals after TBI.

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“…3,8,18 Many studies have described the disproportionate burden of injury experienced by children who live in socioeconomically disadvantaged environments. [18][19][20][21] Three equity gaps have been broadly described: differences in injury epidemiology (including frequency and severity), 3,17,22 differences in postinjury care (including access to resources such as rehabilitation), 18,19 and differences in child and family resilience to recover and thrive after sustaining such an injury. 7,23,24 This study demonstrated that patients living in neighborhoods with a higher MCDI were at a significantly higher risk of sustaining a severe TBI than patients living in more socioeconomically advantaged neighborhoods.…”

Section: Discussionmentioning

confidence: 99%

“…There have been other studies that have demonstrated that injuries related to interpersonal violence are higher in communities that are more deprived, due to a higher risk of abuse, assault, and firearms. 14,20 Kelly et al demonstrated that Black, Hispanic, and Native American children had worse clinical outcomes. 3 Black children may experience more severe injuries as a result of interpersonal violence from assault or firearms at a higher rate than other racial groups.…”

Section: Discussionmentioning

confidence: 99%

Utility of the material community deprivation index as a metric to identify at-risk children for severe traumatic brain injury

Gaulden,

Trinidad,

Moody

et al. 2023

Neurosurgical Focus

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OBJECTIVE Pediatric traumatic brain injury (TBI) is a significant cause of morbidity and mortality with lasting effects including neurological deficits and psychological comorbidities. Recent studies have shown that social determinants of health are key factors that impact clinical outcomes in other pediatric traumatic injuries, suggesting that these health disparities may have a significant impact on patients sustaining TBI as well. The purpose of this study was to retrospectively review a cohort of pediatric patients diagnosed with TBI and elucidate the relationships among socioeconomic deprivation, patient-specific demographics, and morbidity and mortality. METHODS The authors conducted a retrospective cross-sectional analysis of pediatric patients (≤ 18 years of age) treated for TBI at a level I pediatric trauma center between 2016 and 2020. Patients with concussion-related injuries without intracranial findings and those with nonaccidental trauma were excluded from the study. In addition to evaluating basic patient demographics, the authors geocoded patient addresses to allow identification of the patient’s home census tract using the material community deprivation index (MCDI). The MCDI is a unique composite index score created by the combination of six census variables and ranges from 0 to 1 in severity. RESULTS Of the 513 patients included in this study, 71 (13.8%) were diagnosed with severe TBI, 28 (5.5%) with moderate TBI, and 414 (80.7%) with mild TBI. Patients in quartile 4 (MCDI ≥ 0.45) were at a significantly higher risk of having a severe TBI than patients in quartile 1 (OR 2.29, 95% CI 1.1–4.71; p = 0.02). Black patients were more likely to have a firearm-related TBI (OR 3.74, 95% CI 2.01–8.7; p = 0.018) than non-Black patients. Patients who lived in a neighborhood with a lower MCDI were significantly more likely to be discharged home than those who lived in an area with a higher MCDI (OR 2.78, 95% CI 7.90–32.93; p < 0.001). CONCLUSIONS This study demonstrated that inequities continue to exist within the pediatric TBI population and that the MCDI is a valuable tool to identify at-risk subpopulations. More specifically, patients who lived in a neighborhood with a higher MCDI were at higher risk of sustaining a severe TBI. By partnering with communities, families, and policymakers, healthcare providers could serve as advocates for these patients and work to minimize the social disparities that continue to exist.

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Socioeconomic Factors and Pediatric Injury

Cited by 15 publications

References 64 publications

Characteristics of Sports-Related Injuries Presenting to a Pediatric Emergency Department

Characteristics of Sports-Related Injuries Presenting to a Pediatric Emergency Department

A Multidimensional Approach to Assessing Factors Impacting Health-Related Quality of Life after Pediatric Traumatic Brain Injury

Utility of the material community deprivation index as a metric to identify at-risk children for severe traumatic brain injury

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