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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Socioeconomic disparities in infant mortality after nonaccidental trauma: a multicenter study
Erika L Rangel1, Randall S Burd, Richard A Falcone
1Division of Pediatric and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
Insights
Socioeconomic factors significantly impact mortality in abused infants. Lower income and lack of private insurance increase the risk of death, highlighting disparities in child abuse outcomes.
Area of Science:
- Pediatric Trauma
- Public Health
- Health Disparities
Background:
- Abuse-related mortality disparities exist between minority and white infants.
- The influence of socioeconomic status on outcomes for abused infants remains unevaluated.
- This study addresses the impact of socioeconomic status and race on outcomes for abused infants.
Purpose of the Study:
- To determine the impact of socioeconomic status and race on outcomes for abused infants.
- To analyze multi-institutional data on infant abuse outcomes.
- To identify socioeconomic predictors of mortality in abused infants.
Main Methods:
- Utilized data from nine U.S. pediatric trauma centers over a 5-year period.
- Included infants (<12 months old) with abusive injuries.
- Employed logistic regression to assess the impact of race, income, and insurance status on mortality, controlling for injury severity and Glasgow Coma Scale scores.
Main Results:
- Identified 867 patients with an overall mortality rate of 8.8%.
- Infants without private insurance had 3.8 times greater odds of death.
- Lower income quartiles were associated with higher odds of death, independent of race and injury severity.
- Race was not an independent predictor of mortality, despite higher overall mortality in African American infants.
Conclusions:
- Significant differences in mortality among abused infants are linked to insurance status and income, even after accounting for injury severity.
- These findings underscore the need to understand and address socioeconomic variations in outcomes for abused infants.
- Socioeconomic factors play a critical role in the survival of infants experiencing abuse.
Background:
While disparities in abuse-related mortality between minority and white infants have been reported, the influence of socioeconomic status on outcome has not been evaluated. The goal of this study was to determine the impact of socioeconomic status and race on outcomes for abused infants using multiinstitutional data.
Methods:
Data on infants (<12 months old) with abusive injuries over a 5-year period were obtained from nine U.S. pediatric trauma centers. Demographics, insurance status, Injury Severity Scores, Glasgow Coma Scale scores, median household income and outcomes were recorded. Logistic regression was used to evaluate the impact of race, income and insurance status on mortality.
Results:
There were 867 patients identified with a mortality of 8.8%. Patients without private insurance had a 3.8 times greater odds (give 95% confidence interval) of dying. Those in the lower three quartiles of income also had a higher odds of death even after controlling for race, injury severity, and Glasgow Coma Scale. Although African American infants had a higher overall mortality than whites (11.2% vs. 7.8%, p = 0.14), race was not an independent predictor of mortality (p = 0.98).
Conclusions:
There are significant differences in mortality among abused infants associated with insurance status and income even after controlling for injury severity. These associations show a need to better understand and address socioeconomic variations in outcome.
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