Kids in tough neighborhoods head to ER more often

April 6, 2018 by Serena Gordon, Healthday Reporter

(HealthDay)—Growing up in a disadvantaged neighborhood may mean more visits to the emergency room, a new study suggests.

When children came from areas of "low opportunity," they were about one-third more likely to have been treated at an urgent care center or an than kids from areas with more opportunity.

They were also twice as likely to receive care for an assault-related injury compared to kids in the "highest opportunity" areas.

"Health care studies often look at income for a neighborhood, but we thought more broadly about what in a child's neighborhood could affect their ," explained study author Ellen Kersten, a research specialist at the University of California, San Francisco.

An area of low opportunity isn't just one where people are living in poverty. Instead, the investigators looked at a number of factors, such as:

  • Percentage of school students receiving free lunch,
  • Kids' proficiency in reading and math,
  • Access to early childhood education and participation in these programs,
  • Percentage of adults who attend college,
  • Access to health facilities,
  • Access to healthy food,
  • Proximity to toxic waste,
  • Parks and open spaces,
  • Unemployment and public assistance rates.

For the study, the researchers looked at areas across San Francisco. The study included more than 47,000 youths under 18 who visited an emergency department or urgent care center between 2007 and 2011.

Almost 40 percent of the kids seen in ERs or were seen for respiratory conditions. Fifteen percent of those were diagnosed with asthma. More than a third of the children were seen for conditions that could usually be handled during a doctor visit. About one-third of the visits were due to injury or trauma.

The researchers then looked to see what type of neighborhoods these children were growing up in. They also compared low opportunity neighborhoods to those traditionally defined as low income, based on U.S. Census data. While these areas often overlapped, areas of low opportunity covered more area.

Kersten said this shows that when studies only look at an area's income, they may miss people who need health care assistance.

Race and ethnicity played big roles in with low opportunity.

"More than 3 out of every 4 African-American or Latino patients in our sample lived in a low opportunity neighborhood compared with just 1 out of every 4 white patients," Kersten noted.

"And 82 percent of publicly insured patients lived in low opportunity , compared with 27 percent of privately insured patients. These disparities in neighborhood child opportunity translate into disparities in child health," she added.

Because each low neighborhood has different challenges, the reasons behind the increased ER and urgent care visits vary, Kersten said.

And that means the solution to this problem will need to be individualized by community, "but could include investments in public schools and day cares, improving access to healthy food and parks, and expanding local hiring and housing assistance programs," she added.

Dr. Peter Richel, chief of pediatrics at Northern Westchester Hospital in Mount Kisco, N.Y., reviewed the findings.

"Emergency departments are overutilized by those in the lower income brackets. It's sad to me that not all children have a relationship with a primary care provider," he said.

"While ER doctors are great and well-trained, they're not ideal for routine care for children," Richel explained. "They don't know the patient's history. They don't follow them from newborn to 21, and ERs can be intimidating.

"It's also not ideal from the health care side. It's taxing to the facilities and it's expensive to spend money on highly qualified ER talent to sometimes treat a cold," he noted.

The study was published online April 6 in the journal Pediatrics.

Explore further: Kids from low-income areas fare worse after heart surgery, finds study

More information: Ellen Kersten, Ph.D., research specialist, University of California, San Francisco; Peter Richel, M.D., chief, pediatrics, Northern Westchester Hospital, Mount Kisco, N.Y.; April 6, 2018, Pediatrics, online

Learn about choosing a pediatrician from the American Academy of Pediatrics.

Related Stories

Kids from low-income areas fare worse after heart surgery, finds study

February 23, 2018
Children from low-income neighborhoods had a higher mortality rate and higher hospital costs after heart surgery compared with those from higher-income neighborhoods, found a national study of more than 86,000 kids with congenital ...

Neighborhoods can affect the need for urgent asthma care

October 23, 2017
In a new study presented at CHEST 2017, researchers from Columbia University Medical Center in New York aimed to determine if the associations between combustion-related air pollutant levels and urgent asthma care differed ...

Children's Hospital Colorado research argues for use of medical homes in pediatrics

March 21, 2017
New research from Children's Hospital Colorado (Children's Colorado) argues strongly in favor of the redirection of public funding to invest in improving the use of patient centered medical homes for children with public ...

San Francisco public housing type a strong predictor of kids' use of emergency rooms

December 8, 2014
San Francisco children living in non-redeveloped public housing are 39 percent more likely to repeatedly visit emergency rooms, according to new research from UC San Francisco and UC Berkeley.

Many kids with medicaid use ER as doctor's office: CDC

July 24, 2014
(HealthDay)—Children covered by Medicaid, the publicly funded insurance program for the poor, visit the emergency room for medical care far more often than uninsured or privately insured youngsters, a U.S. survey finds.

Better patient communication needed after urgent care

October 14, 2017
(HealthDay)—Patients and primary care physicians (PCPs) need to communicate better after urgent care visits, and patients value their relationships with their PCPs, according to research conducted by Harris Poll on behalf ...

Recommended for you

App helps hearing-impaired parents know when and why their baby is crying

May 23, 2018
For parents Delbert and Sanaz Whetter a crying baby is a particularly difficult challenge. The Whetters are deaf, so when they're in another room they rely on cameras and remote noise-monitors to help keep an eye on their ...

Pregnancy drug DES might have triggered ADHD in the grandchildren of women who used it

May 21, 2018
A study conducted by researchers at Columbia University's Mailman School of Public Health and Harvard T.H. Chan School of Public Health reported elevated odds for attention deficit hyperactivity disorder (ADHD) in the grandchildren ...

Age-related racial disparity in suicide rates among US youth

May 21, 2018
New research suggests the suicide rate is roughly two times higher for black children ages 5-12 compared with white children of the same age group. The study, funded by the National Institute of Mental Health (NIMH), appears ...

One in 10 parents say their child has gotten sick from spoiled or contaminated food

May 21, 2018
No parent wants to come home from a picnic or restaurant with a little one whose stomachache turns into much worse.

Infant growth patterns affected by type of protein consumed

May 14, 2018
A new study by CU School of Medicine researchers has determined that choices of protein intake from solid foods has a significant impact on infant growth during the first year of life.

Parents say intense gun violence in PG-13 movies appropriate for teens 15 and older

May 14, 2018
Parents are more willing to let their children see PG-13 movies with intense gun violence when the violence appears to be "justified," used in defense of a loved one or for self-protection, than when it has no socially redeeming ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.