Children from disadvantaged neighborhoods experience disproportionate injury from interpersonal violence

JOURNAL OF PEDIATRIC SURGERY(2023)

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摘要
Background: Disparities in pediatric injury have been widely documented and are driven, in part, by dif-ferential exposures to social determinants of health (SDH). Here, we hypothesized that neighborhood socioeconomic deprivation and specific sociodemographic characteristics would be associated with inter-personal violence-related injury admission. Methods: We conducted a retrospective cohort study of all patients <= 16 years, residing in Hamilton County, admitted to our level 1 pediatric trauma center. Residential addresses were geocoded to link admissions with a census tract-level socioeconomic deprivation index. Admissions were categorized as resulting from interpersonal violence or not - based on a mechanism of injury (MOI) of abuse or as-sault. The percentage of interpersonal violence-related injury admissions was compared across patient demographics and neighborhood deprivation index tertiles. These factors were then evaluated with mul-tivariable regression analysis. Results: Interpersonal violence accounted for 6.2% (394 of 6324) of all injury-related admissions. Inter-personal violence-related injury admission was associated with older age, male sex, Black race, public insurance, and living in tertiles of census tracts with higher socioeconomic deprivation. Those living in the most deprived tertile experienced 62.2% of all interpersonal violence-related injury admissions but only 36.9% of non-violence related injury admissions ( p < 0.001). After adjustment, insurance and neigh-borhood deprivation accounted for much of the increase in interpersonal violence-related admissions for Black compared to White children. Conclusions: Children from higher deprivation neighborhoods, who are also disproportionately Black and publicly insured, experience a higher burden of interpersonal violence-related injury admissions. Level of evidence Level III. (c) 2022 Elsevier Inc. All rights reserved.
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关键词
Violence,Pediatric,Injury,Trauma,Neighborhood deprivation,Socioeconomic status
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