Social determinants of health in pediatric scald burns: Is food access an issue?

Authors

Philip Kyung Woo Hong, University of Florida, United States
Juan Pablo Santana, University of Florida, United States
Shawn D. Larson, University of Florida, United States
Amy M. Berger, University of Florida, United States
Lauren A. Indelicato, University of Florida, United States
Janice A. Taylor, University of Florida, United States
Moiz M. Mustafa, University of Florida, United States
Saleem Islam, University of Florida, United StatesFollow
Dan Neal, University of Florida, United States
Robin T. Petroze, University of Florida, United States

Document Type

Article

Department

Paediatric Surgery

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.

Comments

This work was published before the author joined Aga Khan University.

Publication (Name of Journal)

Surgery

Recommended Citation

Woo Hong, P. K., Santana, J. P., Larson, S. D., Berger, A. M., Indelicato, L. A., Taylor, J. A., Mustafa, M. M., Islam, S., Neal, D., Petroze, R. T. (2022). Social determinants of health in pediatric scald burns: Is food access an issue?. Surgery, 172(5), 1510-1515.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_surg_paediatr/66