Related Experiment Video
Updated: Dec 27, 2025
Determining Soil-transmitted Helminth Infection Status and Physical Fitness of School-aged Children
Published on: August 22, 2012
Social Disadvantage, Access to Care, and Disparities in Physical Functioning Among Children Hospitalized with
Arti D Desai1,2, Chuan Zhou1,2, Wren Haaland2
1Department of Pediatrics, University of Washington, Seattle, Washington.
Insights
Social disadvantage and difficulty accessing care negatively impact children's physical functioning before hospitalization. However, these effects diminish after hospital discharge, suggesting improved outcomes post-treatment.
Area of Science:
- Pediatric Health Outcomes
- Health Services Research
- Social Determinants of Health
Background:
- Child health-related quality of life (HRQoL) disparities require targeted interventions.
- Social disadvantage and access to care are critical factors influencing child health.
- Understanding these factors is key to improving pediatric physical functioning.
Purpose of the Study:
- To examine the association between social disadvantage, access to care, and child physical functioning.
- To assess these associations before and after hospitalization for acute respiratory illness.
Main Methods:
- A cohort of 1,325 children (ages 2 weeks to 16 years) and/or caregivers were surveyed.
- Data collected included social disadvantage markers, access to care, and physical functioning (PedsQL).
- Multivariable regression models analyzed associations at baseline and follow-up.
Main Results:
- Patients with social disadvantage markers had significantly lower baseline physical functioning scores.
- Difficulty accessing care was associated with lower physical functioning at both assessment points.
- The negative impact of social disadvantage on physical functioning was reduced post-hospitalization.
Conclusions:
- Social disadvantage and access barriers are linked to poorer baseline physical functioning in children.
- Hospitalization may mitigate some of the negative effects of these factors on physical functioning.
- Further research can explore interventions to sustain improvements post-discharge.
Background And Objectives:
Understanding disparities in child health-related quality of life (HRQoL) may reveal opportunities for targeted improvement. This study examined associations between social disadvantage, access to care, and child physical functioning before and after hospitalization for acute respiratory illness.
Methods:
From July 1, 2014, to June 30, 2016, children ages 8-16 years and/or caregivers of children 2 weeks to 16 years admitted to five tertiary care children's hospitals for three common respiratory illnesses completed a survey on admission and within 2 to 8 weeks after discharge. Survey items assessed social disadvantage (minority race/ ethnicity, limited English proficiency, low education, and low income), difficulty/delays accessing care, and baseline and follow-up HRQoL physical functioning using the Pediatric Quality of Life Inventory (PedsQL, range 0-100). We examined associations between these three variables at baseline and follow-up using multivariable, mixed-effects linear regression models with multiple imputation sensitivity analyses for missing data.
Results:
A total of 1,325 patients and/or their caregivers completed both PedsQL assessments. Adjusted mean baseline PedsQL scores were significantly lower for patients with social disadvantage markers, compared with those of patients with none (78.7 for >3 markers versus 85.5 for no markers, difference -6.1 points (95% CI: -8.7, -3.5). The number of social disadvantage markers was not associated with mean follow-up PedsQL scores. Difficulty/delays accessing care were associated with lower PedsQL scores at both time points, but it was not a significant effect modifier between social disadvantage and PedsQL scores.
Conclusions:
Having social disadvantage markers or difficulty/delays accessing care was associated with lower baseline physical functioning; however, differences were reduced after hospital discharge.
Related Concept Videos
01:31Common Respiratory Disorders
Upper respiratory disorders impact the airways above the vocal cords, encompassing areas like the nose, sinuses, and throat. Various conditions fall under this category, including the common cold and allergic rhinitis. These disorders can stem from several causes,...
01:30Respiratory System Abnormal Finding I: Inspection and Percussion
Inspection Findings
During an inspection, several findings may suggest the presence of respiratory distress or disease. Pursed-lip breathing, where exhalation is slowed by...
01:28Physical Assessment of the Respiratory Tract I: Health History
Subjective Data
Subjective data provides vital information about the patient's health history and symptoms. This data is typically collected through interviews in which patients describe their experiences, symptoms, and concerns.
Health history and...
01:23Assessment of Respiration
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
01:27Physical Assessment of the Respiratory Tract II: Inspection
Chest Configuration
The chest configuration...
01:17Other Pulmonary Disorders