An Innovative Individual-level Socioeconomic Measure Identifies Disparities Among Injured Children At A Level 1 Trauma Center
Rebecca Zhu, Yu Shi, Chung Il Wi, Amy Glasgow, Young Juhn, *Stephanie Polites
Mayo Clinic, Rochester, MN
Background (issue): To determine if socioeconomic status (SES) is associated with type and outcome of injury at a level 1 pediatric trauma center.
Methods: The institutional trauma registry was queried for patients <15 years old from 2011-2020. SES was measured using HOUSES index, a validated SES measure derived from individual housing features by geocoding home addresses and matching to property assessment data. HOUSES z-scores were placed into population-based quartiles (Q1 lowest SES, Q4 highest). Other demographics, injury characteristics, and hospital course data were compared by HOUSES quartiles using standard statistical analyses.
Findings: The 1364 patients were distributed among HOUSES quartiles (29% QI, 21% Q2, 23% Q3, 26% Q4). Patients in Q1 were more likely to be younger, female, minority race, and live in an urban area than those in Q2-Q4 (all p<.05). Q1 patients were more likely to be injured by violence including abuse and assault (10 vs 5%, p=.006) while Q2-Q4 patients were more likely to be injured by sports (17 vs 8%, p<.001). Protective device utilization was lower in Q1 (16 vs 21%, p=.014). No differences in injury severity, transport time, intensive care, need for operation, length of stay, complications, or mortality by HOUSES were found.
Conclusions (implications for practice): Children of the lowest SES in our community disproportionately experience violence and injuries without appropriate protective devices. The predominance of young female minority children in Q1 highlights health inequities in pediatric trauma. HOUSES can aid in identification of a high-risk pediatric population for specific types of injury and guide prevention.
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