Characteristics and neighborhood-level opportunity of assault-injured children in Milwaukee. Inj Epidemiol 2023 Aug 21;10(Suppl 1):43
Date
08/22/2023Pubmed ID
37605186Pubmed Central ID
PMC10441698DOI
10.1186/s40621-023-00453-6Scopus ID
2-s2.0-85168468862 (requires institutional sign-in at Scopus site) 1 CitationAbstract
BACKGROUND: Multiple studies have explored demographic characteristics and social determinants of health in relation to the risk of pediatric assault-related injuries and reinjury. However, few have explored protective factors. The Child Opportunity Index (COI) uses neighborhood-level indicators to measure 'opportunity' based on factors such as education, social environment, and economic resources. We hypothesized that higher 'opportunity' would be associated with less risk of reinjury in assault-injured youth.
METHODS: This was a single-institution, retrospective study at a Level 1 Pediatric Trauma Center. Trauma registry and electronic medical record data were queried for children ≤ 18 years old with assault-related injuries from 1/1/2016 to 5/31/2021. Reinjured children, defined as any child who sustained more than one assault injury, were compared to non-reinjured children. Area Deprivation Index (ADI), a marker of socioeconomic status, and COI were determined through census block and tract data, respectively. A post-hoc analysis examined COI between all assault-injured children, unintentionally injured children, and a state-based normative cohort representative of non-injured children.
RESULTS: There were 55,862 traumatic injury encounters during the study period. Of those, 1224 (2.3%) assault injured children were identified, with 52 (4.2%) reinjured children and 1172 (95.8%) non-reinjured children. Reinjured children were significantly more likely to be older (median age 15.0 [IQR 13.8-17.0] vs. median age 14.0 [IQR 8.8-16.0], p < 0.001) and female (55.8% vs. 37.5%, p = 0.01) than non-reinjured children. COI was not associated with reinjury. There were also no significant differences in race, ethnicity, insurance status, ADI, or mechanism and severity of injury between cohorts. Post-hoc analysis revealed that assault-injured children were more likely to live in areas of lower COI than the other cohorts.
CONCLUSIONS: Compared to children who sustained only one assault during the study period, children who experienced more than one assault were more likely to be older and female. Furthermore, living in an area with more or less opportunity did not influence the risk of reinjury. However, all assault-injured children were more likely to live in areas of lower COI compared to unintentionally injured and a state-based normative cohort. Identification of factors on a social or environmental level that leads to assaultive injury warrants further exploration.
Author List
Georgeades C, Farazi M, Bergner C, Bowder A, Cassidy L, Levas MN, Nimmer M, Flynn-O'Brien KTAuthors
Carisa Bergner Biostatistician II in the Surgery department at Medical College of WisconsinLaura Cassidy PhD Associate Dean, Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Katherine T. Flynn-O'Brien MD, MPH Assistant Professor in the Surgery department at Medical College of Wisconsin
Michael Levas MD Professor in the Pediatrics department at Medical College of Wisconsin
