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Racial and ethnic differences in pediatric unintentional injuries requiring hospitalization
Kristyn Jeffries1, Henry T Puls1, Matthew Hall1,2
1Department of Pediatrics, Division of Hospital Medicine, Children's Mercy Hospitals, Kansas City, Missouri, USA.
Insights
Racial and ethnic minority children face higher hospitalization risks for unintentional injuries. Black children, in particular, show elevated risks for firearm injuries, highlighting disparities in pediatric injury prevention.
Area of Science:
- Pediatric injury prevention
- Health disparities research
- Public health surveillance
Background:
- Unintentional injuries are a leading cause of hospitalization for children.
- Existing research indicates potential racial and ethnic disparities in pediatric injury outcomes.
- Understanding these differences is crucial for targeted prevention strategies.
Purpose of the Study:
- To investigate racial and ethnic disparities in pediatric unintentional injury hospitalizations.
- To analyze these differences across various injury mechanisms and age groups.
- To quantify the excess hospitalizations attributable to these disparities.
Main Methods:
- Retrospective analysis of the 2016 Kids' Inpatient Database.
- Included 98,611 children (≤19 years) hospitalized for unintentional injuries.
- Calculated relative risks (RR) and excess hospitalizations by race/ethnicity and age.
Main Results:
- Black children had higher hospitalization rates than White children for most injury types, except falls.
- The greatest disparity was observed for firearm injuries (RR 9.8).
- An estimated 6263 excess hospitalizations occurred among minority children compared to White children.
Conclusions:
- Racial and ethnic minority children experience disproportionately higher risks for injury hospitalizations.
- These risks vary significantly by injury type and child's age.
- Environmental, societal, and potential provider bias factors may contribute to these disparities.
Background/Objective:
This study aims to comprehensively examine racial and ethnic differences in pediatric unintentional injuries requiring hospitalization by age across injury mechanisms.
Study Design:
This was a retrospective, nationally representative cross-sectional analysis of discharge data within the 2016 Kids' Inpatient Database for 98,611 children ≤19 years with unintentional injuries resulting in hospitalization. Injury categories included passengers and pedestrians injured in a motor vehicle crash, falls, drownings, burns, firearms, drug and nondrug poisonings, suffocations, and other injuries. Relative risk (RR) for injuries requiring hospitalization were calculated for children of Black, Hispanic, and Other races and ethnicities compared with White children, and then RR were further stratified by age. Excessive hospitalizations were calculated as the absolute number of hospitalizations for each race and ethnicity group that would have been avoided if each group had the same rate as White children.
Results:
Black children were significantly more likely to be hospitalized compared with White children for all injury mechanisms except falls, and in nearly all age groups with the greatest RR for firearm injuries (RR 9.8 [95% confidence interval: 9.5-10.2]). Differences were associated with 6263 excessive hospitalizations among all racial and ethnic minority children compared with White children.
Conclusions:
Racial and ethnic minority children represent populations at persistent disproportionate risk for injuries resulting in hospitalization; risk that varies in important ways by injury mechanism and children's age. These findings suggest the importance of the environmental and societal exposures that may drive these differences, but other factors, such as provider bias, may also contribute.
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