Socioeconomic factors in inflicted traumatic brain injury: Examining the area deprivation index.

Abstract

Purpose/objective: Inflicted traumatic brain injury (iTBI), or abusive head injury, is a common cause of mortality and disability among infants and toddlers. Social determinants of health (SDoH) have a critical and multifaceted impact on iTBI, influencing both prevalence and outcomes. The area deprivation index (ADI) is a comprehensive metric of SDoH developed to assist in understanding how community-level socioeconomic factors influence patient outcomes. The current study sought to describe the sociodemographic characteristics, including ADI, of a cohort of 373 infants and young children who sustained an iTBI.

Research method/design: This study was a retrospective analysis utilizing a cohort of pediatric patients treated for iTBI at a large, tertiary care children's hospital serving seven states in the Rocky Mountain region.

Results: Mortality prevalence was higher among older children, and older children were more likely to have a longer stay in the pediatric intensive care unit. Children who were identified as Hispanic/Latino lived in areas with greater socioeconomic disadvantage than children identified as non-Hispanic/Latino. Specifically, participants who were identified as White Hispanic/Latino lived in areas with greater disadvantage than children who were identified as White non-Hispanic/Latino. There were no other significant differences by race. Contrary to hypotheses, ADI was not significantly related to mortality, injury severity, or follow-up visits.

Conclusions/implications: While SDoH are known to influence outcomes in iTBI, it may be necessary to incorporate individual or family-level SDoH variables within this clinical sample and examine the interaction between individual and community-level factors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).