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Published on: December 10, 2013
Social risk factors of recurrent croup
J B Eyring1, Brandon M Hemeyer1, Wesley P Allen1
1Spencer Fox Eccles School of Medicine, United States; University of Utah Department of Otolaryngology - Head & Neck Surgery, United States.
Purpose:
To evaluate associations between recurrent croup and neighborhood-level social determinants of health, including socioeconomic status, education, physical infrastructure, environmental exposure, and healthcare access.
Methods:
We conducted a retrospective study of 252 recurrent and 594 isolated pediatric croup cases from seven hospitals and ten otolaryngology clinics across two health systems. Patient addresses were geocoded and linked to the Agency for Healthcare Research and Quality's Social Determinants of Health database. Multivariate logistic regression was used to assess associations between recurrent croup and neighborhood-level socioeconomic, environmental, and access-related factors.
Results:
Patients with recurrent croup were younger (mean age 3.30 years vs. 4.84 years for isolated croup, p < .0001), and lived in areas of lower household income (p < .05) and educational attainment (p < .01). There were no significant differences in population density, air pollution, or distance to emergency departments between recurrent and isolated croup.
Conclusions:
Social determinants of health, particularly lower household income and education, were associated with recurrent croup. Physicians should consider these factors in the management of recurrent croup and engage in shared decision-making with parents to improve outcomes. Further research is needed to investigate additional environmental and demographic factors.
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