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Pediatric traumas and neighborhood socioeconomic characteristics: A population based study
Inari Listo1, Heli Salmi1, Matti Hästbacka2
1Division of Anesthesiology, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, P.O. Box 340, Helsinki, FI-00029, HUS, Finland; New Children's Hospital, University of Helsinki and Helsinki University Hospital, P.O. Box 347, Helsinki, FI-00029, HUS, Finland.
Insights
Pediatric traumatic emergencies are more frequent in lower socioeconomic status areas. Urban planning may offer a protective effect, warranting further investigation into child health equity.
Area of Science:
- Pediatric Emergency Medicine
- Public Health
- Socioeconomic Determinants of Health
Background:
- Identifying children at risk for trauma is crucial for developing targeted emergency medical services.
- Understanding socioeconomic disparities in pediatric out-of-hospital emergencies is essential to address child health inequities.
Purpose of the Study:
- To investigate the association between socioeconomic status and the incidence of traumatic emergencies in children.
- To compare the incidence of traumatic versus nontraumatic emergencies in relation to socioeconomic factors.
Main Methods:
- Retrospective analysis of ambulance contacts for children aged 0-15 years in Helsinki, Finland (2014-2018).
- Categorization of emergencies into traumatic and nontraumatic, with comparison to socioeconomic markers of the emergency scene and residential areas.
- Statistical analysis to determine the significance of associations between socioeconomic factors and emergency types.
Main Results:
- 35.0% of pediatric ambulance contacts were traumatic emergencies.
- Traumatic emergencies were significantly more common in areas with lower median income, higher unemployment, and lower education levels.
- A higher proportion of pediatric population in a residential area showed a protective effect against traumatic emergencies.
Conclusions:
- Children residing in lower socioeconomic status areas experience a higher incidence of traumatic emergencies.
- Further research into the potential protective role of urban planning on pediatric trauma is recommended.
Background:
Identifying pediatric populations at risk for traumas would enable development of emergency medical services and emergency departments for children. Elucidation of the nature of socioeconomic differences in the incidence of pediatric out-of-hospital emergencies is needed to overcome inequities in child health.
Methods:
We retrieved all ambulance contacts during 17.12.2014-16.12.2018 involving children (0-15 years) in Helsinki, Finland and separated traumatic and nontraumatic emergencies. We compared the incidences of these emergencies in the pediatric population with socioeconomic markers of the scene of the emergency and of the residential area of the child.
Results:
Of 11,742 ambulance contacts involving children 4113 (35.0%) were traumatic. Traumatic emergencies occurred more often in neighborhoods with lower median income/household (P=0.043) and were more common in children living in areas with lower median income/inhabitant (P=0.001), higher unemployment (P<0.001), and lower education (P<0.001). The associations were weaker for traumatic than nontraumatic emergencies. Higher proportion of a pediatric population in a residential area (P=0.005) had a protective effect. Exclusion of clinically unnecessary ambulance responses did not change the results.
Conclusion:
Traumatic emergencies in children are more common in areas with lower socioeconomic status. The possible protective effect of urban planning merits further studies.
Type Of Study:
Prognostic.
Level Of Evidence:
II.
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