The consequences of parental injury: Impacts on children's health care utilization and financial barriers to care.

Abstract

Background: Unintentional traumatic injuries pose a significant public health challenge, impacting not only injured individuals but also their families. Existing research has largely focused on the effects of a child's injury on their family, with limited attention to the consequences of parental injury on children's health. This study aims to explore the consequences of unintentional parental injury on children's health outcomes, health care utilization, and socioeconomic barriers to care.

Methods: We utilized data from the National Health Interview Survey (NHIS) for 2020, 2021, and 2023, creating parent-child dyads where the parent was injured. Injury was defined by a positive response to experiencing an injury and seeking medical consultation after. Children aged 5 years to 17 years and their parents were included. Three outcome domains were examined: health outcomes, health care utilization, and socioeconomic health impacts. Bivariate and logistic regression analyses were conducted to assess the impact of parental injury on these outcomes.

Results: We identified 414 (weighted = 1,338,068) injured parent-child dyads and 10,352 noninjured dyads. Children of injured parents had higher odds of being diagnosed with attention-deficit hyperactivity disorder/attention-deficit disorder (odds ratio [OR], 1.69; 95% confidence interval [CI], 1.31-2.40; p = 0.005), higher Washington Group Composite Disability Scores (OR, 1.77; 95% CI, 1.25-2.47; p = 0.001), and increased injury odds (OR, 2.29; 95% CI, 1.58-3.28; p < 0.001). They also showed higher rates of urgent care visits, with significantly higher emergency department visits (OR, 1.49; 95% CI, 1.02-2.13; p = 0.03). Financial toxicity was significant, with increased odds of delaying (OR, 2.37; 95% CI, 1.14-5.40; p = 0.03) or avoiding care (OR, 3.06; 95% CI, 1.06-7.76; p = 0.02) due to cost.

Conclusion: This study highlights the broad-reaching impact of parental injury on children, including worse health outcomes, increased health care utilization, and significant financial barriers. These findings underscore the need for comprehensive trauma care that addresses the holistic needs of families, incorporating strategies to mitigate both health and socioeconomic challenges.

Level of evidence: Prognostic/Epidemiological; Level II.