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Georgeades C, Farazi M, Bergner C, Bowder A, Cassidy L, Levas MN, Nimmer M, Flynn-O'Brien KT. Characteristics and neighborhood-level opportunity of assault-injured children in Milwaukee. Inj Epidemiol 2023; 10:43. [PMID: 37605186 PMCID: PMC10441698 DOI: 10.1186/s40621-023-00453-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 07/19/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Multiple studies have explored demographic characteristics and social determinants of health in relation to the risk of pediatric assault-related injuries and reinjury. However, few have explored protective factors. The Child Opportunity Index (COI) uses neighborhood-level indicators to measure 'opportunity' based on factors such as education, social environment, and economic resources. We hypothesized that higher 'opportunity' would be associated with less risk of reinjury in assault-injured youth. METHODS This was a single-institution, retrospective study at a Level 1 Pediatric Trauma Center. Trauma registry and electronic medical record data were queried for children ≤ 18 years old with assault-related injuries from 1/1/2016 to 5/31/2021. Reinjured children, defined as any child who sustained more than one assault injury, were compared to non-reinjured children. Area Deprivation Index (ADI), a marker of socioeconomic status, and COI were determined through census block and tract data, respectively. A post-hoc analysis examined COI between all assault-injured children, unintentionally injured children, and a state-based normative cohort representative of non-injured children. RESULTS There were 55,862 traumatic injury encounters during the study period. Of those, 1224 (2.3%) assault injured children were identified, with 52 (4.2%) reinjured children and 1172 (95.8%) non-reinjured children. Reinjured children were significantly more likely to be older (median age 15.0 [IQR 13.8-17.0] vs. median age 14.0 [IQR 8.8-16.0], p < 0.001) and female (55.8% vs. 37.5%, p = 0.01) than non-reinjured children. COI was not associated with reinjury. There were also no significant differences in race, ethnicity, insurance status, ADI, or mechanism and severity of injury between cohorts. Post-hoc analysis revealed that assault-injured children were more likely to live in areas of lower COI than the other cohorts. CONCLUSIONS Compared to children who sustained only one assault during the study period, children who experienced more than one assault were more likely to be older and female. Furthermore, living in an area with more or less opportunity did not influence the risk of reinjury. However, all assault-injured children were more likely to live in areas of lower COI compared to unintentionally injured and a state-based normative cohort. Identification of factors on a social or environmental level that leads to assaultive injury warrants further exploration.
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Affiliation(s)
- Christina Georgeades
- Division of Pediatric Surgery, Department of Surgery, Medical College of Wisconsin, Children's Corporate Center, Suite C320, 999 N 92nd St, Milwaukee, WI, 53226, USA.
| | - Manzur Farazi
- Division of Pediatric Surgery, Department of Surgery, Medical College of Wisconsin, Children's Corporate Center, Suite C320, 999 N 92nd St, Milwaukee, WI, 53226, USA
| | - Carisa Bergner
- Division of Pediatric Surgery, Department of Surgery, Medical College of Wisconsin, Children's Corporate Center, Suite C320, 999 N 92nd St, Milwaukee, WI, 53226, USA
| | - Alexis Bowder
- Division of Pediatric Surgery, Department of Surgery, Medical College of Wisconsin, Children's Corporate Center, Suite C320, 999 N 92nd St, Milwaukee, WI, 53226, USA
| | - Laura Cassidy
- Department of Epidemiology and Social Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Michael N Levas
- Division of Pediatric Emergency Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mark Nimmer
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Katherine T Flynn-O'Brien
- Division of Pediatric Surgery, Department of Surgery, Medical College of Wisconsin, Children's Corporate Center, Suite C320, 999 N 92nd St, Milwaukee, WI, 53226, USA
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