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Asociación entre el índice de oportunidades para los niños y los riesgos sociales a nivel individual
Florinda Islamovic1, Samantha Levano1,2, Hemen Muleta1
1Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore Einstein, Bronx, NY.
Journal of pediatrics. Clinical practice
|September 2, 2025
Resumen
El Índice de Oportunidades Infantiles (COI, por sus siglas en inglés) es un indicador pobre de las necesidades sociales individuales relacionadas con la salud (HRSN, por sus siglas en inglés) de los niños. El COI 3.0 mostró cierta mejora con respecto al COI 2.0 en la identificación de estas necesidades.
Área de la Ciencia:
- Salud pediátrica
- Determinantes sociales de la salud
- Equidad en salud
Sus antecedentes:
- Los índices a nivel de área como el Índice de Oportunidades Infantiles (COI) se utilizan como proxies para las necesidades sociales individuales relacionadas con la salud (HRSN).
- La literatura existente sugiere limitaciones en el uso de estos índices a nivel de área.
- Ningún estudio previo ha evaluado la relación entre la IOC y los HRSN individuales específicamente dentro de la población pediátrica.
Objetivo del estudio:
- Evaluar la relación entre las versiones 2.0 y 3.0 del Índice de Oportunidades Infantiles (COI) y las necesidades sociales relacionadas con la salud a nivel individual (HRSN).
- Evaluar la utilidad del COI como sustituto para la identificación de los HRSN en pacientes pediátricos.
Principales métodos:
- Estudio transversal en el que participaron pacientes pediátricos sometidos a cribado de HRSN en un gran hospital académico.
- Inclusión de 17.760 niños con HRSN y identificadores geográficos.
- Modelos de regresión logística multivariada para analizar las asociaciones entre los tertiles COI y los HRSN, incluidos los cálculos de capacidad predictiva.
Principales resultados:
- El COI normalizado nacional 3.0 indicó una probabilidad significativamente mayor de HRSN en áreas de oportunidad moderada (OR 1.57) y baja (OR 2.34) en comparación con áreas de alta oportunidad.
- El COI normalizado estatal 3.0 mostró probabilidades más altas de HRSN solo en áreas de baja oportunidad (OR 1.87).
- No se encontró una asociación significativa entre los HRSN y el COI 2.0 o el COI metropolitano normalizado 3.0.
Conclusiones:
- El Índice de Oportunidades Infantiles (COI) sirve como una medida contextual, pero es un indicador inadecuado para las necesidades sociales individuales relacionadas con la salud (HRSN).
- Las mejoras observadas de COI 2.0 a 3.0 subrayan la importancia del desarrollo y la actualización continuos del índice.
- Es posible que se necesiten investigaciones adicionales para refinar los índices a nivel de área para una mejor evaluación de las necesidades de salud a nivel individual.
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