Socioeconomic Risk Factors for Pediatric Out-of-hospital Cardiac Arrest: A Statewide Analysis
Introduction: Economic hardship is a major threat to children’s health, implying that pediatric out-of-hospital cardiac arrest (pOHCA) might be promoted by lower incomes and child poverty. To target resources, it is helpful to identify geographical hotspots. Rhode Island is the smallest state by are...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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eScholarship Publishing, University of California
2023-05-01
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| Series: | Western Journal of Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/3rs2q9f5 |
| _version_ | 1797798179902586880 |
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| author | Calvin Lukas Kienbacher Guixing Wei Jason Rhodes Harald Herkner Kenneth A. Williams |
| author_facet | Calvin Lukas Kienbacher Guixing Wei Jason Rhodes Harald Herkner Kenneth A. Williams |
| author_sort | Calvin Lukas Kienbacher |
| collection | DOAJ |
| description | Introduction: Economic hardship is a major threat to children’s health, implying that pediatric out-of-hospital cardiac arrest (pOHCA) might be promoted by lower incomes and child poverty. To target resources, it is helpful to identify geographical hotspots. Rhode Island is the smallest state by area in the United States of America. It has one million inhabitants and is comparable to many larger cities worldwide. We aimed to investigate the possible associations of pOHCA with economic factors and the coronavirus 2019 (COVID-19) pandemic. Our goal was to identify high-risk areas and evaluate whether the COVID-19 pandemic had an influence on delays in prehospital care. Methods: We analyzed all pOHCA cases (patients <18 years of age) in Rhode Island between March 1, 2018–February 28, 2022. We performed Poisson regression with pOHCA as dependent and economic risk factors (median household income [MHI] and child poverty rate from the US Census Bureau) as well as the COVID-19 pandemic as independent variables. Hotspots were identified using local indicators of spatial association (LISA) statistics. We used linear regression to assess the association of emergency nedical services-related times with economic risk factors and COVID-19. Results: A total of 51 cases met our inclusion criteria. Lower MHIs (incidence-rate ratio [IRR]) 0.99 per $1,000 MHI; P=0.01) and higher child poverty rates (IRR 1.02 per percent; P=0.02) were significantly associated with higher numbers of ambulance calls due to pOHCA. The pandemic did not have a significant influence (IRR 1.1; P=0.7). LISA identified 12 census tracts as hotspots (P<0.01). The pandemic was not associated with delays in prehospital care. Conclusion: Lower median household income and higher child poverty rate are associated with higher numbers of pediatric out-of-hospital cardiac arrest. |
| first_indexed | 2024-03-13T03:59:37Z |
| format | Article |
| id | doaj.art-06bb328013bf4708a903816382752daf |
| institution | Directory Open Access Journal |
| issn | 1936-9018 |
| language | English |
| last_indexed | 2024-03-13T03:59:37Z |
| publishDate | 2023-05-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-06bb328013bf4708a903816382752daf2023-06-21T18:00:40ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-90182023-05-0124310.5811/westjem.59107wjem-24-572Socioeconomic Risk Factors for Pediatric Out-of-hospital Cardiac Arrest: A Statewide AnalysisCalvin Lukas Kienbacher0Guixing Wei1Jason Rhodes2Harald Herkner3Kenneth A. Williams4The Warren Alpert Medical School of Brown University, Division of Emergency Medical Services, Department of Emergency Medicine, Providence, Rhode IslandBrown University, Population Studies and Training Center, Spatial Structures in the Social Sciences (S4), Providence, Rhode IslandRhode Island Department of Health, Center for Emergency Medical Services, Providence, Rhode IslandMedical University of Vienna, Department of Emergency Medicine, Vienna, AustriaRhode Island Department of Health, Center for Emergency Medical Services, Providence, Rhode IslandIntroduction: Economic hardship is a major threat to children’s health, implying that pediatric out-of-hospital cardiac arrest (pOHCA) might be promoted by lower incomes and child poverty. To target resources, it is helpful to identify geographical hotspots. Rhode Island is the smallest state by area in the United States of America. It has one million inhabitants and is comparable to many larger cities worldwide. We aimed to investigate the possible associations of pOHCA with economic factors and the coronavirus 2019 (COVID-19) pandemic. Our goal was to identify high-risk areas and evaluate whether the COVID-19 pandemic had an influence on delays in prehospital care. Methods: We analyzed all pOHCA cases (patients <18 years of age) in Rhode Island between March 1, 2018–February 28, 2022. We performed Poisson regression with pOHCA as dependent and economic risk factors (median household income [MHI] and child poverty rate from the US Census Bureau) as well as the COVID-19 pandemic as independent variables. Hotspots were identified using local indicators of spatial association (LISA) statistics. We used linear regression to assess the association of emergency nedical services-related times with economic risk factors and COVID-19. Results: A total of 51 cases met our inclusion criteria. Lower MHIs (incidence-rate ratio [IRR]) 0.99 per $1,000 MHI; P=0.01) and higher child poverty rates (IRR 1.02 per percent; P=0.02) were significantly associated with higher numbers of ambulance calls due to pOHCA. The pandemic did not have a significant influence (IRR 1.1; P=0.7). LISA identified 12 census tracts as hotspots (P<0.01). The pandemic was not associated with delays in prehospital care. Conclusion: Lower median household income and higher child poverty rate are associated with higher numbers of pediatric out-of-hospital cardiac arrest.https://escholarship.org/uc/item/3rs2q9f5 |
| spellingShingle | Calvin Lukas Kienbacher Guixing Wei Jason Rhodes Harald Herkner Kenneth A. Williams Socioeconomic Risk Factors for Pediatric Out-of-hospital Cardiac Arrest: A Statewide Analysis Western Journal of Emergency Medicine |
| title | Socioeconomic Risk Factors for Pediatric Out-of-hospital Cardiac Arrest: A Statewide Analysis |
| title_full | Socioeconomic Risk Factors for Pediatric Out-of-hospital Cardiac Arrest: A Statewide Analysis |
| title_fullStr | Socioeconomic Risk Factors for Pediatric Out-of-hospital Cardiac Arrest: A Statewide Analysis |
| title_full_unstemmed | Socioeconomic Risk Factors for Pediatric Out-of-hospital Cardiac Arrest: A Statewide Analysis |
| title_short | Socioeconomic Risk Factors for Pediatric Out-of-hospital Cardiac Arrest: A Statewide Analysis |
| title_sort | socioeconomic risk factors for pediatric out of hospital cardiac arrest a statewide analysis |
| url | https://escholarship.org/uc/item/3rs2q9f5 |
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