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Relationship between the COVID-19 pandemic and structural inequalities within the pediatric trauma population
BACKGROUND: The COVID-19 pandemic disrupted social, political, and economic life across the world, shining a light on the vulnerability of many communities. The objective of this study was to assess injury patterns before and after implementation of stay-at-home orders (SHOs) between White children...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10683076/ https://www.ncbi.nlm.nih.gov/pubmed/38017506 http://dx.doi.org/10.1186/s40621-023-00475-0 |
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author | Georgeades, Christina Collings, Amelia T. Farazi, Manzur Bergner, Carisa Fallat, Mary E. Minneci, Peter C. Speck, K. Elizabeth Van Arendonk, Kyle J. Deans, Katherine J. Falcone, Richard A. Foley, David S. Fraser, Jason D. Gadepalli, Samir K. Keller, Martin S. Kotagal, Meera Landman, Matthew P. Leys, Charles M. Markel, Troy A. Rubalcava, Nathan S. St. Peter, Shawn D. Sato, Thomas T. Flynn-O’Brien, Katherine T. |
author_facet | Georgeades, Christina Collings, Amelia T. Farazi, Manzur Bergner, Carisa Fallat, Mary E. Minneci, Peter C. Speck, K. Elizabeth Van Arendonk, Kyle J. Deans, Katherine J. Falcone, Richard A. Foley, David S. Fraser, Jason D. Gadepalli, Samir K. Keller, Martin S. Kotagal, Meera Landman, Matthew P. Leys, Charles M. Markel, Troy A. Rubalcava, Nathan S. St. Peter, Shawn D. Sato, Thomas T. Flynn-O’Brien, Katherine T. |
author_sort | Georgeades, Christina |
collection | PubMed |
description | BACKGROUND: The COVID-19 pandemic disrupted social, political, and economic life across the world, shining a light on the vulnerability of many communities. The objective of this study was to assess injury patterns before and after implementation of stay-at-home orders (SHOs) between White children and children of color and across varying levels of vulnerability based upon children’s home residence. METHODS: A multi-institutional retrospective study was conducted evaluating patients < 18 years with traumatic injuries. A “Control” cohort from an averaged March-September 2016–2019 time period was compared to patients injured after SHO initiation-September 2020 (“COVID” cohort). Interactions between race/ethnicity or social vulnerability index (SVI), a marker of neighborhood vulnerability and socioeconomic status, and the COVID-19 timeframe with regard to the outcomes of interest were assessed using likelihood ratio Chi-square tests. Differences in injury intent, type, and mechanism were then stratified and explored by race/ethnicity and SVI separately. RESULTS: A total of 47,385 patients met study inclusion. Significant interactions existed between race/ethnicity and the COVID-19 SHO period for intent (p < 0.001) and mechanism of injury (p < 0.001). There was also significant interaction between SVI and the COVID-19 SHO period for mechanism of injury (p = 0.01). Children of color experienced a significant increase in intentional (COVID 16.4% vs. Control 13.7%, p = 0.03) and firearm (COVID 9.0% vs. Control 5.2%, p < 0.001) injuries, but no change was seen among White children. Children from the most vulnerable neighborhoods suffered an increase in firearm injuries (COVID 11.1% vs. Control 6.1%, p = 0.001) with children from the least vulnerable neighborhoods having no change. All-terrain vehicle (ATV) and bicycle crashes increased for children of color (COVID 2.0% vs. Control 1.1%, p = 0.04 for ATV; COVID 6.7% vs. Control 4.8%, p = 0.02 for bicycle) and White children (COVID 9.6% vs. Control 6.2%, p < 0.001 for ATV; COVID 8.8% vs. Control 5.8%, p < 0.001 for bicycle). CONCLUSIONS: In contrast to White children and children from neighborhoods of lower vulnerability, children of color and children living in higher vulnerability neighborhoods experienced an increase in intentional and firearm-related injuries during the COVID-19 pandemic. Understanding inequities in trauma burden during times of stress is critical to directing resources and targeting intervention strategies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40621-023-00475-0. |
format | Online Article Text |
id | pubmed-10683076 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-106830762023-11-30 Relationship between the COVID-19 pandemic and structural inequalities within the pediatric trauma population Georgeades, Christina Collings, Amelia T. Farazi, Manzur Bergner, Carisa Fallat, Mary E. Minneci, Peter C. Speck, K. Elizabeth Van Arendonk, Kyle J. Deans, Katherine J. Falcone, Richard A. Foley, David S. Fraser, Jason D. Gadepalli, Samir K. Keller, Martin S. Kotagal, Meera Landman, Matthew P. Leys, Charles M. Markel, Troy A. Rubalcava, Nathan S. St. Peter, Shawn D. Sato, Thomas T. Flynn-O’Brien, Katherine T. Inj Epidemiol Research BACKGROUND: The COVID-19 pandemic disrupted social, political, and economic life across the world, shining a light on the vulnerability of many communities. The objective of this study was to assess injury patterns before and after implementation of stay-at-home orders (SHOs) between White children and children of color and across varying levels of vulnerability based upon children’s home residence. METHODS: A multi-institutional retrospective study was conducted evaluating patients < 18 years with traumatic injuries. A “Control” cohort from an averaged March-September 2016–2019 time period was compared to patients injured after SHO initiation-September 2020 (“COVID” cohort). Interactions between race/ethnicity or social vulnerability index (SVI), a marker of neighborhood vulnerability and socioeconomic status, and the COVID-19 timeframe with regard to the outcomes of interest were assessed using likelihood ratio Chi-square tests. Differences in injury intent, type, and mechanism were then stratified and explored by race/ethnicity and SVI separately. RESULTS: A total of 47,385 patients met study inclusion. Significant interactions existed between race/ethnicity and the COVID-19 SHO period for intent (p < 0.001) and mechanism of injury (p < 0.001). There was also significant interaction between SVI and the COVID-19 SHO period for mechanism of injury (p = 0.01). Children of color experienced a significant increase in intentional (COVID 16.4% vs. Control 13.7%, p = 0.03) and firearm (COVID 9.0% vs. Control 5.2%, p < 0.001) injuries, but no change was seen among White children. Children from the most vulnerable neighborhoods suffered an increase in firearm injuries (COVID 11.1% vs. Control 6.1%, p = 0.001) with children from the least vulnerable neighborhoods having no change. All-terrain vehicle (ATV) and bicycle crashes increased for children of color (COVID 2.0% vs. Control 1.1%, p = 0.04 for ATV; COVID 6.7% vs. Control 4.8%, p = 0.02 for bicycle) and White children (COVID 9.6% vs. Control 6.2%, p < 0.001 for ATV; COVID 8.8% vs. Control 5.8%, p < 0.001 for bicycle). CONCLUSIONS: In contrast to White children and children from neighborhoods of lower vulnerability, children of color and children living in higher vulnerability neighborhoods experienced an increase in intentional and firearm-related injuries during the COVID-19 pandemic. Understanding inequities in trauma burden during times of stress is critical to directing resources and targeting intervention strategies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40621-023-00475-0. BioMed Central 2023-11-28 /pmc/articles/PMC10683076/ /pubmed/38017506 http://dx.doi.org/10.1186/s40621-023-00475-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Georgeades, Christina Collings, Amelia T. Farazi, Manzur Bergner, Carisa Fallat, Mary E. Minneci, Peter C. Speck, K. Elizabeth Van Arendonk, Kyle J. Deans, Katherine J. Falcone, Richard A. Foley, David S. Fraser, Jason D. Gadepalli, Samir K. Keller, Martin S. Kotagal, Meera Landman, Matthew P. Leys, Charles M. Markel, Troy A. Rubalcava, Nathan S. St. Peter, Shawn D. Sato, Thomas T. Flynn-O’Brien, Katherine T. Relationship between the COVID-19 pandemic and structural inequalities within the pediatric trauma population |
title | Relationship between the COVID-19 pandemic and structural inequalities within the pediatric trauma population |
title_full | Relationship between the COVID-19 pandemic and structural inequalities within the pediatric trauma population |
title_fullStr | Relationship between the COVID-19 pandemic and structural inequalities within the pediatric trauma population |
title_full_unstemmed | Relationship between the COVID-19 pandemic and structural inequalities within the pediatric trauma population |
title_short | Relationship between the COVID-19 pandemic and structural inequalities within the pediatric trauma population |
title_sort | relationship between the covid-19 pandemic and structural inequalities within the pediatric trauma population |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10683076/ https://www.ncbi.nlm.nih.gov/pubmed/38017506 http://dx.doi.org/10.1186/s40621-023-00475-0 |
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