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Racial Disparities and Pressure Injuries Among Hospitalized Patients
Jill Cox1, Charlotte Thomas Hawkins
1Jill Cox, PhD, RN, APN-C, CWOCN, FAAN, is Clinical Professor, Rutgers University School of Nursing, and Wound/Ostomy/Continence Advanced Practice Nurse, Englewood Health, Englewood, New Jersey. Charlotte Thomas Hawkins, PhD, RN, FAAN, is Associate Professor, Rutgers University School of Nursing, and Associate Dean, Nursing Science. Acknowledgment: Funding was provided by Rutgers University Center for Health Services Research and Policy. The authors have disclosed no other financial relationships related to this article. Submitted May 2, 2022; accepted in revised form June 15, 2022.
Insights
Black patients admitted to New Jersey hospitals experienced higher rates of severe pressure injuries (PIs) and faced greater social challenges. These findings reveal significant racial disparities in pressure injury care and outcomes.
Area of Science:
- Health Services Research
- Health Disparities
- Clinical Outcomes
Background:
- Pressure injuries (PIs) represent a significant healthcare burden, disproportionately affecting vulnerable populations.
- Understanding demographic and social factors associated with PIs is crucial for addressing health inequities.
Purpose of the Study:
- To examine demographic factors, hospitalization details, comorbidities, and social determinants of health among racial groups with pressure injuries (PIs).
- To identify racial disparities in PI diagnosis and severity in New Jersey hospitals.
Main Methods:
- Retrospective analysis of the 2018 New Jersey State Inpatient Database.
- Included 17,781 patients with primary or secondary PI diagnosis (sacrum, buttocks, heels).
- Compared Black patients (n=3,515) with other racial groups (n=14,266).
Main Results:
- Black patients had higher admission rates for PIs and a greater proportion of stage 4 PIs.
- Black patients were younger, resided in lower-income areas, and more often used Medicaid.
- Conversely, Black patients had a lower proportion of stage 1 PIs.
Conclusions:
- Significant racial disparities exist in pressure injury prevalence and severity in New Jersey.
- Further research on skin tone's impact and the role of social determinants in PIs is warranted.
- Addressing these disparities is critical for equitable healthcare outcomes.
Objective:
To describe the demographic factors, hospitalization-related factors, comorbid states, and social determinants of health among racial groups in a sample of patients with a primary or secondary diagnosis of pressure injury (PI) admitted to New Jersey hospitals during the year 2018.
Methods:
Researchers conducted a retrospective analysis of the Health Care Utilization Project's 2018 New Jersey State Inpatient Database. Patients with a primary or secondary diagnosis of PI (sacrum, buttocks, or heels; N = 17,781) were included in the analytic sample. Analysis compared patients who identified as Black (n = 3,515) with all other racial groups combined (n = 14,266).
Results:
A higher proportion of Black patients were admitted for a PI (P < .001) and had higher proportions of stage 4 PIs (P < .001) but a lower proportion of stage 1 PIs (P < .001). Higher proportions of Black patients were younger, resided in lower income communities, and identified Medicaid as their primary payor source.
Conclusions:
Results highlight the racial disparities that exist among patients with PIs in this diverse state and may represent a much larger problem. Clinical research examining the impact of skin tone rather than by racial group is needed. The impact of racial disparities on social determinants of health with regard to PIs remains largely unknown, but its importance cannot be underestimated.
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