Neighborhood-based Social Determinants of Health are Associated With Decreased Helmet Use in Young Children

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery Pub Date : 2025-04-03 DOI:10.1016/j.jpedsurg.2025.162315

Caroline Q. Stephens , Alexandra Highet , Ava Yap , Christopher Newton , Willieford Moses

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引用次数: 0

Abstract

Purpose

We sought to determine the association between neighborhood-level social determinants of health (SDoH) and protective helmet use for young children involved in bicycle, scooter, and skateboard crashes. We hypothesized that children from disadvantaged communities would be less likely to be wearing helmets at the time of their crash.

Methods

A retrospective cohort study was performed of all children ≤10 years old who presented after bicycle, scooter, and skateboard crashes to a single Level 1 Pediatric Trauma Center (7/1/2017–6/30/2021). Geocoding linked patient addresses to state-Area Deprivation Index (ADI) and Social Vulnerability Index (SVI). Multivariable logistic regression modeling investigated associations between neighborhood-level SDoH and helmet use, controlling for age, sex, and racialization. ADI and SVI were scaled to present decile change (0 = least disadvantaged, 10 = most disadvantaged).

Results

220 children were in bicycle, scooter, and skateboard crashes, 56 % of whom were not wearing helmets. The median age was 7.6 years, 71 % were male, 52 % were on public insurance, and 63 % had minoritized racialization. Neighborhood-level SDoH indices were significantly associated with helmet use, with a 27 % (95 % CI 1.10–1.39, p < 0.001) increase in the odds of no helmet use for every decile increase in overall SVI, and a 23 % (95 % CI 1.12–1.44, p < 0.001) increase in the odds of no helmet use every decile increase in ADI.

Conclusions

Helmet use in young children was found to be closely associated with community structural factors. Neighborhood-level SDoH indices may be an effective tool for identifying at-risk communities for the development of injury prevention interventions.

Level of Evidence

Prognosis Study, Level II.

查看原文本刊更多论文

基于社区的健康社会决定因素与幼儿头盔使用减少有关。

目的：我们试图确定社区层面的健康社会决定因素（SDoH）与涉及自行车、踏板车和滑板碰撞的幼儿的防护头盔使用之间的关系。我们假设，来自弱势社区的儿童在撞车时不太可能戴头盔。方法：对所有≤10岁的儿童进行回顾性队列研究，这些儿童在自行车、滑板车和滑板碰撞后就诊于一家一级儿科创伤中心（7/1/2017-6/30/2021）。地理编码将患者地址与州-地区剥夺指数（ADI）和社会脆弱性指数（SVI）联系起来。多变量logistic回归模型调查了社区水平的SDoH和头盔使用之间的关系，控制了年龄、性别和种族化。ADI和SVI以十分位数变化表示（0=最弱势，10=最弱势）。结果：220名儿童在自行车、踏板车和滑板中发生碰撞，其中56%没有戴头盔。中位年龄为7.6岁，71%为男性，52%为公共保险，63%为少数族裔化。社区水平的SDoH指数与头盔使用显著相关，为27% （95% CI 1.10-1.39）。结论：幼儿头盔使用与社区结构因素密切相关。社区水平的SDoH指数可能是一个有效的工具，以确定有风险的社区，以发展伤害预防干预措施。证据等级：预后研究II级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of pediatric surgery 医学-外科

CiteScore

1.10

自引率

12.50%

发文量

569

审稿时长

38 days

期刊介绍： The journal presents original contributions as well as a complete international abstracts section and other special departments to provide the most current source of information and references in pediatric surgery. The journal is based on the need to improve the surgical care of infants and children, not only through advances in physiology, pathology and surgical techniques, but also by attention to the unique emotional and physical needs of the young patient.