TY  - JOUR
PY  - 2023//
TI  - Relationship between the COVID-19 pandemic and structural inequalities within the pediatric trauma population
JO  - Injury epidemiology
A1  - Georgeades, Christina
A1  - Collings, Amelia T.
A1  - Farazi, Manzur
A1  - Bergner, Carisa
A1  - Fallat, Mary E.
A1  - Minneci, Peter C.
A1  - Speck, K. Elizabeth
A1  - Van Arendonk, Kyle J.
A1  - Deans, Katherine J.
A1  - Falcone, Richard A. Jr
A1  - Foley, David S.
A1  - Fraser, Jason D.
A1  - Gadepalli, Samir K.
A1  - Keller, Martin S.
A1  - Kotagal, Meera
A1  - Landman, Matthew P.
A1  - Leys, Charles M.
A1  - Markel, Troy A.
A1  - Rubalcava, Nathan S.
A1  - St Peter, Shawn D.
A1  - Sato, Thomas T.
A1  - Flynn-O'Brien, Katherine T.
SP  - e62
EP  - e62
VL  - 10
IS  - Suppl 1
N2  - 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. <br><br>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. <br><br>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). <br><br>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.<p />  <p>Language: en</p>
LA  - en
SN  - 2197-1714
UR  - http://dx.doi.org/10.1186/s40621-023-00475-0
ID  - ref1
ER  -