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Published on: May 11, 2015

Child Opportunity Index Influences Pediatric Pulmonary Hypertension Outcomes: Analyses From the Pediatric Health

Jai K Khurana1, Stuart Lipsitz2, Diana L Geisser3

  • 1Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts, USA.

JACC. Advances
|May 28, 2026
PubMed

Insights

Social determinants of health significantly impact pediatric pulmonary hypertension (PH) outcomes. Lower socioeconomic opportunity, minority race, public insurance, and longer travel distance are linked to increased PH mortality in children.

Area of Science:

  • Pediatric Health Outcomes
  • Social Determinants of Health
  • Pulmonary Hypertension Research

Background:

  • Social determinants of health (SDoH) impact pediatric pulmonary hypertension (PH) outcomes.
  • Characterizing these SDoH is crucial for improving care.

Purpose of the Study:

  • To examine associations between SDoH and pediatric PH outcomes.
  • To identify specific SDoH factors contributing to mortality in pediatric PH patients.

Main Methods:

  • Retrospective cohort study of 24,321 pediatric PH patients from 47 children's hospitals (2016-2022).
  • Utilized International Classification of Diseases-10 codes for patient identification.
  • Analyzed SDoH including Child Opportunity Index (COI), race/ethnicity, insurance, urbanicity, and distance, assessing their association with mortality.

Main Results:

  • Mortality rate was 7.0% (1,702 deaths).
  • Higher mortality observed in lower COI quintiles, with public insurance, Black/African American race, and greater home-to-hospital distance.
  • Patients in the highest COI quintile had significantly lower odds of mortality (adjusted OR: 0.78; 95% CI: 0.67-0.90) compared to the lowest.

Conclusions:

  • Lower Child Opportunity Index, Black/African American race, public insurance, and increased home-to-hospital distance are associated with higher mortality in pediatric PH.
  • These findings highlight the critical role of SDoH in pediatric PH outcomes and underscore the need for targeted interventions.
Abstract

Keywords:
COIPHISmortality outcomespediatric pulmonary hypertensionretrospective studysocial determinants of health

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