Pediatric traumas and neighborhood socioeconomic characteristics: A population based study.


Journal

Journal of pediatric surgery
ISSN: 1531-5037
Titre abrégé: J Pediatr Surg
Pays: United States
ID NLM: 0052631

Informations de publication

Date de publication:
Apr 2021
Historique:
received: 16 04 2020
revised: 15 05 2020
accepted: 28 05 2020
pubmed: 11 7 2020
medline: 25 6 2021
entrez: 11 7 2020
Statut: ppublish

Résumé

Identifying pediatric populations at risk for traumas would enable development of emergency medical services and emergency departments for children. Elucidation of the nature of socioeconomic differences in the incidence of pediatric out-of-hospital emergencies is needed to overcome inequities in child health. We retrieved all ambulance contacts during 17.12.2014-16.12.2018 involving children (0-15 years) in Helsinki, Finland and separated traumatic and nontraumatic emergencies. We compared the incidences of these emergencies in the pediatric population with socioeconomic markers of the scene of the emergency and of the residential area of the child. Of 11,742 ambulance contacts involving children 4113 (35.0%) were traumatic. Traumatic emergencies occurred more often in neighborhoods with lower median income/household (P=0.043) and were more common in children living in areas with lower median income/inhabitant (P=0.001), higher unemployment (P<0.001), and lower education (P<0.001). The associations were weaker for traumatic than nontraumatic emergencies. Higher proportion of a pediatric population in a residential area (P=0.005) had a protective effect. Exclusion of clinically unnecessary ambulance responses did not change the results. Traumatic emergencies in children are more common in areas with lower socioeconomic status. The possible protective effect of urban planning merits further studies. Prognostic. II.

Sections du résumé

BACKGROUND BACKGROUND
Identifying pediatric populations at risk for traumas would enable development of emergency medical services and emergency departments for children. Elucidation of the nature of socioeconomic differences in the incidence of pediatric out-of-hospital emergencies is needed to overcome inequities in child health.
METHODS METHODS
We retrieved all ambulance contacts during 17.12.2014-16.12.2018 involving children (0-15 years) in Helsinki, Finland and separated traumatic and nontraumatic emergencies. We compared the incidences of these emergencies in the pediatric population with socioeconomic markers of the scene of the emergency and of the residential area of the child.
RESULTS RESULTS
Of 11,742 ambulance contacts involving children 4113 (35.0%) were traumatic. Traumatic emergencies occurred more often in neighborhoods with lower median income/household (P=0.043) and were more common in children living in areas with lower median income/inhabitant (P=0.001), higher unemployment (P<0.001), and lower education (P<0.001). The associations were weaker for traumatic than nontraumatic emergencies. Higher proportion of a pediatric population in a residential area (P=0.005) had a protective effect. Exclusion of clinically unnecessary ambulance responses did not change the results.
CONCLUSION CONCLUSIONS
Traumatic emergencies in children are more common in areas with lower socioeconomic status. The possible protective effect of urban planning merits further studies.
TYPE OF STUDY METHODS
Prognostic.
LEVEL OF EVIDENCE METHODS
II.

Identifiants

pubmed: 32646665
pii: S0022-3468(20)30372-9
doi: 10.1016/j.jpedsurg.2020.05.040
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

760-767

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Inari Listo (I)

Division of Anesthesiology, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, P.O. Box 340, Helsinki, FI-00029, HUS, Finland; New Children's Hospital, University of Helsinki and Helsinki University Hospital, P.O. Box 347, Helsinki, FI-00029, HUS, Finland. Electronic address: inari.listo@hus.fi.

Heli Salmi (H)

Division of Anesthesiology, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, P.O. Box 340, Helsinki, FI-00029, HUS, Finland; New Children's Hospital, University of Helsinki and Helsinki University Hospital, P.O. Box 347, Helsinki, FI-00029, HUS, Finland.

Matti Hästbacka (M)

Emergency Medicine and Services, University of Helsinki and Helsinki University Hospital, P.O. Box 340, Helsinki, FI-00029, HUS, Finland.

Mitja Lääperi (M)

Emergency Medicine and Services, University of Helsinki and Helsinki University Hospital, P.O. Box 340, Helsinki, FI-00029, HUS, Finland.

Jelena Oulasvirta (J)

Division of Anesthesiology, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, P.O. Box 340, Helsinki, FI-00029, HUS, Finland.

Tiina Etelälahti (T)

Emergency Medicine and Services, University of Helsinki and Helsinki University Hospital, P.O. Box 340, Helsinki, FI-00029, HUS, Finland.

Markku Kuisma (M)

Emergency Medicine and Services, University of Helsinki and Helsinki University Hospital, P.O. Box 340, Helsinki, FI-00029, HUS, Finland.

Heini Harve-Rytsälä (H)

Emergency Medicine and Services, University of Helsinki and Helsinki University Hospital, P.O. Box 340, Helsinki, FI-00029, HUS, Finland.

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Classifications MeSH