Neighborhood Conditions and Recurrent Emergency Department Utilization by Children in the United States

Abstract

Objective To determine the associations of social and physical neighborhood conditions with recurrent emergency department (ED) utilization by children in the US. Study designThis cross-sectional study was conducted with the National Survey of Children's Health from 2016 to 2018 to determine the associations of neighborhood characteristics of cohesion, safety, amenities, and detractors with the proportions of children aged 1-17 years with recurrent ED utilization, defined as 2 or more ED visits during the past 12 months. A multivariable regression model was used to determine the independent association of each neighborhood characteristic with recurrent ED utilization controlling for individual-level characteristics.Results In this study of 98 711 children weighted to a population of 70 million nationally, children had significantly greater rates of recurrent ED utilization if they lived in neighborhoods that were not cohesive, were not safe, or had detractors present (all P < .001). With adjustment for individual-level covariates and the other neighborhood characteristics, only neighborhood detractors were independently associated with recurrent ED utilization

Adverse Social Determinants of Health and Gaps in Care Coordination Among Children

“…It also adds an additional SDoH measure, adverse neighborhood and built environment, based on the Healthy People 2030 framework (Healthy People 2030, n.d.). While other studies have shown that adverse neighborhood and built environment are associated with higher ED visits among children (Chang et al, 2021), our study considers this adverse SDoH as well as 4 others. Finally, this study introduces a measure of the burden of social determinants facing the child.…”

Supplemental Nutrition Assistance Program Education reductions during COVID-19 may have exacerbated health inequities

“…Low-income, Black, and Latino communities experience disproportionately poorer health, including higher rates of type 2 diabetes ( Gaskin et al, 2014 ), more emergency room visits ( Leal & Chaix, 2011 ), higher obesity prevalence ( Kirby & Kaneda, 2005 ), and lower life expectancy ( Chang et al, 2021 ; Suglia et al, 2016 ) than their higher income and white, non-Latino counterparts. Neighborhood-level disadvantages ( Do & Finch, 2008 ; Leal & Chaix, 2011 ), including healthcare access ( Kirby & Kaneda, 2005 ) and aspects of social and physical environments (e.g., poverty, social cohesion, crime, safety, food access) ( Christian et al, 2011 ; Fonge et al, 2020 ; Gebreab et al, 2017 ; Hilmers et al, 2012 ; Morris et al, 2019 ; Singh et al, 2010 ) contribute to these disparities.…”

Association of Neighborhood Conditions and Resources for Children With Life Expectancy at Birth in the US

“…[12][13][14][15][16] The social and environmental conditions in which people live likely account for part of the association between neighborhood poverty and health. 17 Neighborhood opportunity for children has been associated with health outcomes in children, including hospitalizations, acute care visits, infant health, mental health, and cardiometabolic risk factors. [18][19][20][21][22][23][24][25][26] Interventions to improve life expectancy in socially vulnerable populations are challenging but possible.…”

“…These community-level conditions include educational, health, environmental, and socioeconomic factors . The social and environmental conditions in which people live likely account for part of the association between neighborhood poverty and health . Neighborhood opportunity for children has been associated with health outcomes in children, including hospitalizations, acute care visits, infant health, mental health, and cardiometabolic risk factors …”