Social determinants of health in pediatric trauma: Associations with injury mechanisms and outcomes in the context of the COVID-19 pandemic - 22/02/24
, Oliver B. Lao a , Holly L. Neville a , Brian K. Yorkgitis b , Henry L. Chang c, d , Keith Thatch c, d , Donald Plumley e , Shawn D. Larson b , John W. Fitzwater f , Michele Markley g , Felipe Pedroso h , Anne Fischer i , Lindsey B. Armstrong d , Robin T. Petroze b , Christopher W. Snyder d, ⁎
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Abstract |
Background |
Relationships between social determinants of health and pediatric trauma mechanisms and outcomes are unclear in context of COVID-19.
Methods |
Children <16 years old injured between 2016 and 2021 from ten pediatric trauma centers in Florida were included. Patients were stratified by high vs. low Social Vulnerability Index (SVI). Injury mechanisms studied were child abuse, ATV/golf carts, and firearms. Mechanism incidence trends and mortality were evaluated by interrupted time series and multivariable logistic regression.
Results |
Of 19,319 children, 68% and 32% had high and low SVI, respectively. Child abuse increased across SVI strata and did not change with COVID. ATV/golf cart injuries increased after COVID among children with low SVI. Firearm injuries increased after COVID among children with high SVI. Mortality was predicted by injury mechanism, but was not independently associated with SVI, race, or COVID.
Conclusion |
Social vulnerability influences pediatric trauma mechanisms and COVID effects. Child abuse and firearm injuries should be targeted for prevention.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Social determinants of health (SDOH) profoundly impact risks for and recovery from a variety of diseases. |
• | Studies have sought to estimate the impact of societal shifts on the type and severity of pediatric traumatic injuries. |
• | This study helps characterize the complex relationships between childhood injuries and social determinants of health. |
• | Child abuse is increasing among all social vulnerability strata, highlighting the need for an unbiased screening tool. |
Keywords : Pediatric injury, COVID-19, Social determinants of health, Social vulnerability, Child abuse, Firearms
Plan
Vol 228
P. 107-112 - février 2024 Retour au numéro
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