142nd APHA Annual Meeting and Exposition

Home Events & Meetings Annual Meeting Schedule & Program

Online Program

Annual Meeting Recordings are now available for purchase

315216
Lower Regional Pediatric in-Hospital Mortality Albiet Racial Disparities

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 4:45 PM - 5:00 PM

Laurens Holmes Jr., MD, DrPH , Office of Health Equity and Inclusion, Nemours Alfred I. DuPont Hospital for Children, Wilmington, DE
Alexandra LaHurd, Research Assistant , Department of Biological Sciences, University of Delaware, Newark, DE
Brianne Earnest, Student Researcher , Office of Health Equity and Inclusion, Nemours Alfred I. DuPont Hospital for Children, Wilmington, DE
Pat Oceanic , Office of Health Equity and Inclusion, Nemours Alfred I. DuPont Hospital for Children, Wilmington, DE
Diane Fitzgerald , Office of Health Equity and Inclusion, Nemours Alfred I. DuPont Hospital for Children, Wilmington, DE
Kelli Grant , Office of Health Equity and Inclusion, Nemours Alfred I. DuPont Hospital for Children, Wilmington, DE
Arie Nettles , Office of Inclusion and Health Equity, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN
Kirk Dabney , Office of Health Equity and Inclusion, Nemours Alfred I. DuPont Hospital for Children, Wilmington, DE
Audio (mp3) recording Recorded Presentation (mp4)
PURPOSE: Pediatric mortality (PM) continues to vary by race/ethnicity, and racial/ethnic minorities tend to bear disproportionately the burden. We aimed to assess the prevalence of PM, racial/ethnic disparities, and possible explanation for the variations. 

METHODS: Using a non-concurrent cohort study, we examined the medical records of patients diagnosed with any pediatric condition during 2009 and 2010 in our institution (Delaware Valley). Death from all causes was the primary outcome variable. Other variables studied were race, vital status, sex, length of stay (LOS), severity of illness (SOI), income and insurance status. Chi-square statistic and logistic regression models were used. 

RESULTS:  The in-hospital pediatric mortality prevalence was relatively low (86 deaths, 0.5%) compared to similar settings in U.S (national average range 0.8% to 1.1%).  African Americans (AA) and Some Other Race (SOR) had slightly higher overall mortality compared to others, AA (2.6%) and SOR (3.5%). Income indicated an inverse trend with mortality; compared to children in the lowest (1st) quartile those in 2nd, 3rd, and 4th were 7%, 26% and 37% less likely to die respectively. Relative to Caucasians, Asians were  61% less likely to die, while   AA were 5% and  SOR were 48% more likely to die, OR,1.48, 95% CI,1.15-1.91. After controlling for potential confounders (SOI, insurance status, LOS), racial disparities did not persist between Caucasians and SOR, adjusted OR = 1.08, 99% CI = 0.75-1.5.

CONCLUSION:  In-hospital pediatric mortality prevalence is relatively low, and racial disparities in PM exist, but did not persist after controlling for insurance, SOI, and LOS.

Learning Areas:

Epidemiology

Learning Objectives:
Assess the prevalence of PM, racial/ethnic disparities, and possible explanation for the variations

Keyword(s): Mortality, Pediatrics

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I'm well trained in internal medicine and public health specifically epidemiology and biostatistics. Currently, I'm a professor of Molecular Epidemiology at the University of Delaware. I conceptualized the study, facilitated data collection, analyzed the data, interpreted the results, and addressed the discussion and conclusion. Very importantly, I directed the preparation of the manuscript, which is on its final phase for submission for concentration for publication by a reputable peer review scientific journal.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4419.0: Topics in Social and Health Disparities