Children From Low-Opportunity Neighborhoods More Likely to Visit Emergency Department Multiple Times

Past research has shown that children living in the lowest income neighborhoods account for twice as many emergency department visits as children from the highest income neighborhoods, nationally. In the May 2018 Pediatrics, authors of, “Neighborhood Child Opportunity and Individual-Level Pediatric Acute Care Useand Diagnoses,” took the concept further by analyzing neighborhoods through an index that considers environmental, economic and social factors such as school poverty, exposure to toxic waste, adult education and proximity to parks. For the study (published online April 6), researchers analyzed health records of 47,175 patients between 1 day and 18 years old in San Francisco who visited an emergency or urgent care department at any of six hospital sites between Jan. 1, 2007, and Dec. 31, 2011. They found that children living in low and very low opportunity neighborhoods had significantly greater odds of to using acute care medical services four or more times a year – often for medical issues that are preventable or treatable in a primary care setting. Children in very low-opportunity neighborhoods had more than two times the odds of an acute care visit for an assault-related injury compared to children in the highest opportunity neighborhoods. The authors recommend the use of the “Child Opportunity Index” for a more nuanced assessment of community needs than use of neighborhood income alone. They suggest the index can be used to guide treatment, prevention and intervention strategies to better address disparities in neighborhood contexts where children live. The authors also describe their findings in a video that will be posted online April. 6.

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The American Academy of Pediatrics is an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds