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Socioeconomic and Racial and/or Ethnic Disparities in Multisystem Inflammatory Syndrome
Karina Javalkar1,2,3,4, Victoria K Robson1,2,3,4, Lukas Gaffney1,2,3
1Departments of Medicine and.
Insights
Children from lower socioeconomic status (SES) or higher social vulnerability index (SVI) backgrounds, and Hispanic or Black children faced increased risks for multisystem inflammatory syndrome in children (MIS-C). Further research is needed to address health inequities.
Area of Science:
- Pediatric Health
- Epidemiology
- Health Disparities
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a serious condition linked to COVID-19.
- Understanding socioeconomic and racial/ethnic disparities in MIS-C is crucial for targeted interventions.
Purpose of the Study:
- To investigate socioeconomic status (SES) and social vulnerability index (SVI) disparities in MIS-C diagnosis.
- To examine racial and/or ethnic disparities in MIS-C diagnosis and clinical severity.
Main Methods:
- A multicenter, retrospective case-control study compared MIS-C patients with five control groups.
- Socioeconomic status (SES) and social vulnerability index (SVI) were assessed using census-based data.
- Multivariable logistic regression analyzed associations between SES, SVI, race/ethnicity, and MIS-C outcomes.
Main Results:
- Hispanic and Black children, and those from the lowest SES quartile or highest SVI quartile, had increased odds of MIS-C diagnosis.
- Socioeconomic status (SES) and social vulnerability index (SVI) were similar between MIS-C and COVID-19 patients.
- No significant association was found between SES, SVI, race, or ethnicity and MIS-C disease severity.
Conclusions:
- Lower SES, higher SVI, Hispanic ethnicity, and Black race are independent risk factors for MIS-C.
- These findings highlight critical health inequities in MIS-C diagnosis.
- Further research is needed to develop targeted interventions to improve health equity for affected children.
Objectives:
To characterize the socioeconomic and racial and/or ethnic disparities impacting the diagnosis and outcomes of multisystem inflammatory syndrome in children (MIS-C).
Methods:
This multicenter retrospective case-control study was conducted at 3 academic centers from January 1 to September 1, 2020. Children with MIS-C were compared with 5 control groups: children with coronavirus disease 2019, children evaluated for MIS-C who did not meet case patient criteria, children hospitalized with febrile illness, children with Kawasaki disease, and children in Massachusetts based on US census data. Neighborhood socioeconomic status (SES) and social vulnerability index (SVI) were measured via a census-based scoring system. Multivariable logistic regression was used to examine associations between SES, SVI, race and ethnicity, and MIS-C diagnosis and clinical severity as outcomes.
Results:
Among 43 patients with MIS-C, 19 (44%) were Hispanic, 11 (26%) were Black, and 12 (28%) were white; 22 (51%) were in the lowest quartile SES, and 23 (53%) were in the highest quartile SVI. SES and SVI were similar between patients with MIS-C and coronavirus disease 2019. In multivariable analysis, lowest SES quartile (odds ratio 2.2 [95% confidence interval 1.1-4.4]), highest SVI quartile (odds ratio 2.8 [95% confidence interval 1.5-5.1]), and racial and/or ethnic minority background were associated with MIS-C diagnosis. Neither SES, SVI, race, nor ethnicity were associated with disease severity.
Conclusions:
Lower SES or higher SVI, Hispanic ethnicity, and Black race independently increased risk for MIS-C. Additional studies are required to target interventions to improve health equity for children.
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