Abstract
Background
Burn injury risk, severity, and outcomes have been associated with socioeconomic status.
Limited data exist to evaluate health access-related influences at a structural population
level. This study evaluated factors at the Census-tract level, specifically evaluating
food access and social vulnerability in pediatric scald burns.
Methods
A single-institution retrospective review using the trauma registry and electronic
medical record was conducted of pediatric burns between 2016 and 2020. Home address
was coded to the Census-tract level and bulk analyzed. Socioeconomic metrics of the
home environment were evaluated from publicly available databases, the United States
Food and Drug Administration Food Access Research Atlas, and the Centers for Disease
Control’s Social Vulnerability Index.
Results
There were 840 patients that met inclusion criteria (49.8% scald, N = 418). The mean total body surface area for scalds was 6.6% with an age of 10.2
years; 76% (n = 317) of scalds had Medicaid, and 15% (n = 63) were due to hot noodles. Scalds occurred more in females (45.7%, N = 191 vs 28.0%, N = 118; P < .0001), non-White race (62.7%, N = 262 vs 29.1%, N = 123; P < .0001), and low-income and low-food access populations (39.8%, N = 147 vs 30.4%, N = 116; P = .007). Low-food access Black populations showed increased scald injury (18% [interquartile
range 6–35] vs 10% [interquartile range 4–25]), whereas all other populations showed
no association. The patients with scalds had a higher overall social vulnerability
index (0.67 vs 0.62, P = .008).
Conclusion
Often related to poverty, health access, and health equity, population-level social
determinants of health like social vulnerability and food access have significant
impact on health care and should influence health outreach and systems improvement.
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References
- Social complexity and risk for pediatric burn injury: a systematic review.J Burn Care Res. 2019; 40: 478-499
- Socioeconomic status and outcomes after burn injury.J Burn Care Res. 2016; 37 (e56–e62)
- Social and economic factors associated with the risk of burn injury.Burns. 2007; 33: 958-965
- Influence of race and neighborhood on the risk for and outcomes of burns in the elderly in North Carolina.Burns. 2011; 37: 762-769
- Association between socioeconomic status and burn injury severity.Burns. 2009; 35: 482-490
- Burn injury outcome differences in Native Americans.Burns. 2019; 45: 494-501
- A national study of the effect of race, socioeconomic status, and gender on burn outcomes.J Burn Care Res. 2017; 38: 161-168
- Social determinants of health and child maltreatment: a systematic review.Pediatr Res. 2020; 89: 269-274
- Epidemiology and trend of US pediatric burn hospitalizations, 2003–2016.Burns. 2021; 47: 551-559
- Epidemiology and outcomes of pediatric burns over 35 years at Parkland Hospital.Burns. 2016; 42: 202-208
- Basic Information about the Built Environment.(Accessed February 23, 2022.)
- CDC/ATSDR Social Vulnerability Index | Place and Health | ATSDR.(Accessed February 9, 2022)
- Profiles in social vulnerability: the association of social determinants of health with postoperative surgical outcomes.Surgery. 2021; 170: 1777-1784
- Using the social vulnerability index to examine local disparities in emergent and elective cholecystectomy.J Surg Res. 2019; 243: 160-164
- Disparities and access to healthy food in the United States: a review of food deserts literature.Health Place. 2010; 16: 876-884
- Poverty and obesity: the role of energy density and energy costs.Am J Clin Nutr. 2004; 79: 6-16
- The consequences of living in a small-town food desert: mixed methods evidence from a quasi-experiment.. 2020; 7: 563-581
- Interventions to address food insecurity among adults in Canada and the US: a systematic review and meta-analysis.JAMA Heal Forum. 2021; 2 (e212001)e212001
- Association of living in urban food deserts with mortality from breast and colorectal cancer.Ann Surg Oncol. 2021; 28: 1311-1319
- Evaluating an urban pediatric hospital’s scald burn prevention program.Inj Epidemiol. 2021; 8: 1-6
- 84 pediatric scald burns: using geographic information systems to identify high risk communities.J Burn Care Res. 2021; 42: S58-S59
- Still too hot: examination of water temperature and water heater characteristics 24 years after manufacturers adopt voluntary temperature setting.J Burn Care Res. 2013; 34: 281-287
- https://www.safekids.org/tip/burns-and-scalds-prevention-tipsDate: Accessed February 14, 2022
- Length of stay per total body surface area burn relative to mechanism: a pediatric injury quality improvement collaborative study.J Burn Care Res. 2022; 43: 863-867
- Social determinants of health and child maltreatment: a systematic review.Pediatr Res. 2020; 89: 269-274
- The social determinants of health: it’s time to consider the causes of the causes.Public Health Rep. 2014; 129: 19-31
- Does payer type influence pediatric burn outcomes? A national study using the healthcare cost and utilization project kids’ inpatient database.J Burn Care Res. 2016; 37: 314-320
- Association of historic housing policy, modern day neighborhood deprivation and outcomes after inpatient hospitalization.Ann Surg. 2021; 274: 985-991
- Effect of Supplemental Nutrition Assistance Program–Education (SNAP-Ed) on food security and dietary outcomes.Nutr Rev. 2019; 77: 903-921
- Supplemental Nutrition Assistance Program (SNAP) participation and health care expenditures among low-income adults.JAMA Intern Med. 2017; 177: 1642-1649
Article info
Publication history
Published online: August 28, 2022
Accepted:
June 30,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
