AOFAS On the Same Page: Inequities in Pediatric Care-Health equity in Pediatric Trauma

Health equity in Pediatric Trauma

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The review article “Health Inequities in Pediatric Trauma” by Kayton et al. explores the disparities present in pediatric trauma care in the United States, influenced significantly by social determinants of health (SDOH). These determinants, encompassing economic, educational, and social factors, affect key domains such as access to care, gun violence, child abuse, head trauma, burn injuries, and orthopedic trauma.<br /><br />The article highlights that children, particularly those from underserved communities, face significant barriers in accessing specialized pediatric trauma care. The shortage of Pediatric Trauma Centers (PTCs) compared to Adult Trauma Centers (ATCs) results in higher mortality rates, with rural and minority populations particularly affected due to limited access.<br /><br />Child abuse is identified as a critical issue, with disparities affected by factors such as insurance and socioeconomic status. Similarly, gun violence is a leading cause of death among children, with higher incidence rates in impoverished and lower socioeconomic communities.<br /><br />Head trauma, often leading to significant long-term disability, is guided by racial and socioeconomic disparities that limit the recognition and treatment of injuries. Moreover, burn injuries in children are frequent and disproportionately affect those from lower socioeconomic backgrounds, with scald and thermal burns being most common.<br /><br />Orthopedic injuries represent a large proportion of pediatric trauma, with disparities existing based on race and insurance status, adversely affecting access to appropriate treatments and outcomes.<br /><br />The review calls for a culturally competent delivery of prevention strategies and highlights the need for equitable design in pediatric trauma systems to address identified barriers. It emphasizes the importance of recognizing disparities in regions with high poverty rates and among racial/ethnic minorities to optimize care and achieve health equity in pediatric trauma.

Keywords

pediatric trauma

health inequities

social determinants of health

access to care

gun violence

child abuse

head trauma

burn injuries

orthopedic trauma

health equity