image: The PAS 2018 Meeting, taking place in Toronto on May 5-8, 2018, brings together thousands of pediatric scientists and other health care providers to improve the health and well-being of children worldwide. view more
Credit: Pediatric Academic Societies
TORONTO, May 5, 2018 - After adjusting for poverty, rates of child physical abuse (CPA) hospitalizations only varied for black children across the urban-rural spectrum, according to findings of a new study examining the rates of CPA hospitalizations and urban-rural status of children's county of residence. In addition, central metro counties remain important areas for prevention efforts, particularly for black children. Findings from the study will be presented during the Pediatric Academic Societies (PAS) 2018 Meeting in Toronto.
This study used the 2012 Kids' Inpatient Database and U.S. Census data. CPA hospitalizations for black, non-Hispanic white and Hispanic children <5 years of age were identified using discharge codes and categorized by the urban-rural status of children's county of residence: central metro, fringe/small metro and rural. Chi-square tests assessed for differences in CPA hospitalizations between urban-rural categories. Rates of CPA hospitalizations for the total child and race/ethnicity-stratified populations were calculated for each urban-rural category. Rates were adjusted using race/ethnicity and poverty and compared using Poisson regression.
The study found that there were 3,082 CPA hospitalizations involving children residing in central metro (32.0 percent), fringe/small metro (53.0 percent) and rural (15.0 percent) counties. Abused rural children, compared to both metro categories, were younger (p= 0.002), more likely to have public insurance (p= 0.008), live in zip codes with lower median household incomes (p< 0.001) and be victims of abusive head trauma (p< 0.001).
The unadjusted rates of CPA hospitalizations were: 16.9 per 100,000 total children, 29.3 per 100,000 black children, 15.4 per 100,000 non-Hispanic white children and 13.1 per 100,000 Hispanic children. Adjusted CPA hospitalization rates for total child populations did not vary across urban-rural categories (p= 0.63). However, the poverty-adjusted rate of CPA hospitalizations for black children decreased 34.8 percent from central metro to rural (p= 0.001). Adjusted rates of CPA hospitalizations for non-Hispanic white and Hispanic children did not vary across urban-rural categories.
Rural counties have higher child poverty and less access to social services. The limited existing literature is conflicting on how CPA rates may vary across the urban-rural spectrum. Understanding these population-level data could inform policy and CPA prevention strategies. Further study of protective and risk factors contributing to these differences may inform future policy and prevention initiatives.
###
Dr. Henry T. Puls, one of the authors of the study, will present findings from "Urban-Rural Residence & Rates of Child Physical Abuse Hospitalizations: A National Population-Based Study" during the PAS 2018 Meeting on Saturday, May 5 at 1:15 p.m. EDT. Reporters interested in an interview with Dr. Puls should contact PAS2018@piercom.com.
Please note: Only the abstract is being presented at the meeting. In some cases, the researcher may have additional data to share with media.
The PAS 2018 Meeting, taking place in Toronto on May 5-8, 2018, brings together thousands of pediatric scientists and other health care providers to improve the health and well-being of children worldwide. For more information about the PAS 2018 Meeting, please visit http://www.pas-meeting.org.
About The Pediatric Academic Societies (PAS) Meeting
The Pediatric Academic Societies (PAS) Meeting brings together thousands of pediatricians and other health care providers united by a common mission: improve the health and well-being of children worldwide. This international gathering includes researchers, academics, as well as clinical care providers and community practitioners. Presentations cover issues of interest to generalists as well as topics critical to a wide array of specialty and sub-specialty areas. The PAS Meeting is produced through a partnership of four pediatric organizations that are leaders in the advancement of pediatric research and child advocacy: American Pediatric Society, Society for Pediatric Research, Academic Pediatric Association and American Academy of Pediatrics. For more information, please visit http://www.pas-meeting.org. Follow us on Twitter @PASMeeting and #PAS2018, or like us on Facebook.
PAS Media Contact:
(214) 217-7300
PAS2018@piercom.com
PAS Press Office (May 5-8, 2018):
(832) 371-6239
Abstract: Urban-Rural Residence & Rates of Child Physical Abuse Hospitalizations: A National Population-Based Study
Background: Rural counties have higher child poverty and less access to social services. The limited existing literature is conflicting on how child physical abuse (CPA) rates may vary across the urban-rural spectrum. Understanding these population-level data could inform policy and CPA prevention strategies.
Objective: To determine if the rates of CPA hospitalizations vary by the urban-rural status of children's county of residence.
Design/Methods: This study used the 2012 Kids' Inpatient Database and US Census data. CPA hospitalizations for Black, non-Hispanic White, and Hispanic children <5 years of age were identified using discharge codes and categorized by the urban-rural status of children's county of residence: central metro, fringe/small metro, and rural. Chi-square tests assessed for differences in CPA hospitalizations between urban-rural categories. Rates of CPA hospitalizations for the total child and race/ethnicity-stratified populations were calculated for each urban-rural category. Rates were adjusted using race/ethnicity and poverty and compared using Poisson regression.
Results: There were 3,082 CPA hospitalizations involving children residing in central metro (32.0%), fringe/small metro (53.0%), and rural (15.0%) counties (Table 1). Abused rural children, compared to both metro categories, were younger (p= 0.002), more likely to have public insurance (p= 0.008), live in ZIP codes with lower median household incomes (p< 0.001), and be victims of abusive head trauma (p< 0.001). The unadjusted rates of CPA hospitalizations were: 16.9 per 100,000 total children, 29.3 per 100,000 Black children, 15.4 per 100,000 non-Hispanic White children, and 13.1 per 100,000 Hispanic children. Adjusted CPA hospitalization rates for total child populations did not vary across urban-rural categories (p= 0.63). However, the poverty-adjusted rate of CPA hospitalizations for Black children decreased 34.8% from central metro to rural (p= 0.001; Figure 1). Adjusted rates of CPA hospitalizations for non-Hispanic White and Hispanic children did not vary across urban-rural categories.
Conclusion(s): After adjusting for poverty, rates of CPA hospitalizations only varied for Black children across the urban-rural spectrum. Central metro counties remain important areas for prevention efforts, particularly for Black children. Further study of protective and risk factors contributing to these differences may inform future policy and prevention initiatives.
Authors: Henry Puls, Jessica Bettenhausen, Jessica Markham, Jessica Markham, Jacqueline Walker, Kathryn Kyler, Mary Ann Queen, Matt Hall