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Neighborhood Poverty and Distance to Pediatric Hospital Care
Lauren Brown1, Urbano L França2, Michael L McManus2
1Division of Critical Care, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital (L Brown, UL França, and ML McManus), Boston, Mass; Harvard Medical School (L Brown, UL França, and ML McManus), Boston, Mass; Department of Anesthesiology, Mass General Brigham, Brigham and Women's Hospital (L Brown), Boston, Mass.
Academic Pediatrics
|February 8, 2023
Summary
Neighborhood poverty is linked to greater distances to pediatric hospital care, with disadvantaged areas being significantly farther away. This disparity may impact children's health outcomes.
Area of Science:
- Public Health
- Health Services Research
- Geographic Information Systems (GIS) in Healthcare
Background:
- Access to pediatric inpatient care is crucial for child health.
- Neighborhood socioeconomic status, specifically poverty, may influence geographic access to healthcare facilities.
- Understanding these spatial relationships is vital for addressing health disparities.
Purpose of the Study:
- To investigate the association between neighborhood poverty and the geographic accessibility of pediatric inpatient services.
- To quantify the differences in distance to capable pediatric hospitals based on varying levels of neighborhood deprivation.
Main Methods:
- Retrospective, cross-sectional study utilizing hospital, demographic (2010 census), and geographic data from 2017-18.
- Analysis included acute care hospitals across 17 states, covering a substantial portion of the US population.
- Geographic access was measured by distance to the nearest pediatric hospital, stratified by the Area Deprivation Index (ADI) and urbanicity.
Main Results:
- A significant linear relationship was observed between neighborhood poverty and increased median distance to pediatric hospital care (Pearson r = 0.986, P < .001).
- Children in the most impoverished neighborhoods (highest ADI deciles) lived a median of 13.8 miles from care, compared to 2.5 miles for those in the most affluent neighborhoods.
- These disparities in distance were consistent across rural, suburban, and urban settings, with disadvantaged suburban children being three times more likely to live over 20 miles from care.
Conclusions:
- Poorer neighborhoods exhibit substantially greater distances to pediatric hospital care compared to affluent neighborhoods.
- These findings highlight potential geographic barriers contributing to disparities in pediatric health outcomes.
- The study underscores the need for targeted interventions to improve equitable access to essential pediatric services.
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