Causal Mediation of Neighborhood-Level Pediatric Hospitalization Inequities

Population-wide racial inequities in child health outcomes are well documented. Less is known about causal pathways linking inequities and social, economic, and environmental exposures. Here, we sought to estimate the total inequities in population-level hospitalization rates and determine how much...

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Published in:Pediatrics (Evanston) 2024-04, Vol.153 (4), p.1
Main Authors: Brokamp, Cole, Jones, Margaret N, Duan, Qing, Rasnick Manning, Erika, Ray, Sarah, Corley, Alexandra M S, Michael, Joseph, Taylor, Stuart, Unaka, Ndidi, Beck, Andrew F
Format: Article
Language:English
Subjects:
Air pollution
Asthma
Census
Childrens health
Diabetes mellitus (insulin dependent)
Health disparities
Hospitalization
Housing
Mental disorders
Pediatrics
Population studies
Population-based studies
Regression analysis
Sickle cell disease
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container_title Pediatrics (Evanston)
container_volume 153
creator Brokamp, Cole
Jones, Margaret N
Duan, Qing
Rasnick Manning, Erika
Ray, Sarah
Corley, Alexandra M S
Michael, Joseph
Taylor, Stuart
Unaka, Ndidi
Beck, Andrew F
description Population-wide racial inequities in child health outcomes are well documented. Less is known about causal pathways linking inequities and social, economic, and environmental exposures. Here, we sought to estimate the total inequities in population-level hospitalization rates and determine how much is mediated by place-based exposures and community characteristics. We employed a population-wide, neighborhood-level study that included youth
doi_str_mv 10.1542/peds.2023-064432
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We calculated census tract-level hospitalization rates per 1000 children, which ranged from 10.9 to 143.0 (median 45.1; interquartile range 34.5 to 60.1) across included tracts. For every 10% increase in the marginalized population, the tract-level hospitalization rate increased by 6.2% (95% confidence interval: 4.5 to 8.0). After adjustment for tract-level community material deprivation, crime risk, English usage, housing tenure, family composition, hospital access, greenspace, traffic-related air pollution, and housing conditions, no inequity remained (0.2%, 95% confidence interval: -2.2 to 2.7). Results differed when considering subsets of asthma, type 1 diabetes, sickle cell anemia, and psychiatric disorders. 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subjects Air pollution
Asthma
Census
Childrens health
Diabetes mellitus (insulin dependent)
Health disparities
Hospitalization
Housing
Mental disorders
Pediatrics
Population studies
Population-based studies
Regression analysis
Sickle cell disease
title Causal Mediation of Neighborhood-Level Pediatric Hospitalization Inequities
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