Socioeconomic Status, Rurality, and Pediatric Critical Care Admission.

Area of Science:

• Pediatric critical care
• Public health
• Socioeconomic determinants of health

Background:

• Neighborhood socioeconomic deprivation is linked to increased pediatric critical illness.
• Structural factors contributing to these disparities require further investigation.

Purpose of the Study:

• To examine the relationship between area-level socioeconomic deprivation, rurality, and pediatric critical care admission rates.
• To identify specific populations at higher risk for critical care admission.

Main Methods:

• Retrospective cohort study utilizing linked data from British Columbia, Canada (2014-2023).
• Inclusion of children aged 0-17 years admitted to intensive care units.
• Analysis of age, sex, rurality, and neighborhood situational vulnerability using Poisson regression models.

Main Results:

• Higher incidence of critical care admission was observed in rural areas and regions with greater socioeconomic disadvantage.
• The association between socioeconomic vulnerability and critical care admission was significant in rural settings but not in urban centers.
• Children in the most deprived rural areas experienced the highest critical care admission rates.

Conclusions:

• Children residing in rural areas and socioeconomically deprived neighborhoods have a disproportionately higher burden of critical care admissions.
• The link between socioeconomic vulnerability and critical care incidence is specific to rural and small population centers.
• Targeted strategies are essential to address disparities and improve access to pediatric acute care in underserved regions.