Demography of pediatric emergency care in Halifax, Canada

Demography affects emergency department (ED) utilization and influences the health care needs of patients, yet the demographics of the caregivers who accompany children to pediatric EDs are not well described. The objective of this study was to provide a demographic description of this population. The hypothesis was that single parent status, annual income less than 20,000 dollars, and education no greater than high school constitute a social triad that might reduce the ability to provide health care for a sick child.

Over a 1-month period, a convenience survey of caregivers who brought children to a pediatric ED was conducted. Twelve hundred surveys were distributed to 1733 eligible subjects. Social and economic determinants were captured, including age, gender, visible minority status, income group, employment, single parent status and education level.

In total, 1018 (85%) of 1200 surveys were returned - a population response rate of 59%. Single parent status, income less than 20,000 dollars/yr, and education no greater than high school were found to be risk factors for altered delivery of health care. Overall, 40.9% of caregivers had at least one risk factor, including 43.2% of women, 63.4% of those under 30 years of age, 65.1% of those with visible minority status, and 71.6% of women who were from a visible minority. In addition, 41.7% of single parents had no more than a high school education, and 75.7% of single parent families had incomes of less than 40,000 dollars per year.

It was found that a high level of educational, social and financial disadvantage in our population. These factors may adversely affect parental capability to provide health care at home for their child. The extent of this problem in other regions is not well defined and should be a focus of future research. It is recommended that inquiry into parental income, education and single parent status be a routine part of the history in pediatric emergency populations.