Ethnoracial And Socioeconomic Disparities In Pediatric Burn Care In Southern Connecticut
Nensi Melissa Ruzgar1, Griffin Coghill2, *Patricia Morrell3, Alisa Savetamal3, *Emily Christison-Lagay3
1Yale School of Medicine, New Haven, CT;2New York Medical College, Valhalla, NY;3Department of Surgery, Yale School of Medicine, New Haven, CT
Background: Recent studies have identified ethnoracial and socioeconomic disparities in access and outcomes in trauma patients; however, these disparities are yet to be explored for pediatric burn injuries. Here, we studied the demographic distributions of pediatric burn patients over 7 years.
Methods: Between 2009-2016, patients aged<18-years presenting with a burn injury were retrospectively reviewed across three hospitals in Southern Connecticut. Distribution of clinical factors were compared between ethnoracial and socioeconomic groups.
Findings: 1281 patients were identified with mean age at injury of 6.21±0.20 years and 47% female. Most common injuries were scald (47%) and contact (34%). First-, second-, and third-degree burns made up 15%, 52%, and 3% of injuries, respectively; 2% resulted in intensive care admissions. Black and Hispanic/Latinx patients made up 36% and 35%, respectively; both were overrepresented in the cohort compared to the distribution expected based on zip-code (Table, p<0.001). A larger proportion of Black patients presented later than 24 hours after injury than White patients (B=23.9%, W=17.7%, p=0.0311) and received social work evaluations (B=43.6%, W=33.7%, p=0.0039). Those presenting later than 24 hours post-injury had lower average household income per zip-code (<24hours=$56487±904, 24+hours=$52437±1530, p=0.0230).
Conclusions: Trends in Southern Connecticut show an increased burden of pediatric burn injuries in Black and Hispanic/Latinx patients, and more frequent presentation delays for those from poorer neighborhoods. This calls for further exploration of the impact of implicit bias, structural barriers, and care coordination-related factors on pediatric burn care.
|Demographics||Distribution in study group (n=1281 [%])||Expected mean % per zip code(mean %±SD)||p-value|
|Race||Black/AfricanAmerican||461 (36.0%)||23.5% ± 0.4%||<0.0001|
|White/Caucasian||362 (28.3%)||57.7% ± 0.6%|
|Other||458 (35.8%)||18.8% ± 1.0%|
|Ethnicity||Hispanic/Latinx||444 (34.7%||25.1% ± 0.5%||<0.0001|
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