Neighborhood risk: Socioeconomic status and hospital admission for pediatric burn patients in Rhode Island

Burns ◽  
2020 ◽  
Author(s):  
Mary A. Hunter ◽  
Lauren E. Schlichting ◽  
Michelle L. Rogers ◽  
David T. Harrington ◽  
Patrick M. Vivier
Keyword(s):  
Socioeconomic Status ◽  
Hospital Admission ◽  
Rhode Island ◽  
Burn Patients ◽  
Neighborhood Risk

scholarly journals GRANDPARENTAL CAREGIVING AND CO-RESIDENCE, SOCIOECONOMIC STATUS, AND MORTALITY IN RHODE ISLAND CITIES AND TOWNS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S319-S320
Author(s):  
Julia Broccoli ◽  
Steven A Cohen ◽  
Mary L Greaney
Keyword(s):  
Socioeconomic Status ◽  
Health Outcomes ◽  
Rhode Island ◽  
Living Arrangements ◽  
Financial Burden ◽  
Primary Caregivers ◽  
Population Level ◽  
Mortality Data ◽  
Physical And Mental Health ◽  
Linear Regression Modeling

Abstract Grandparents co-residing with their grandchildren is becoming increasingly more common, with over 1.5 million grandchildren living with their grandchildren in the U.S. Furthermore, the number of grandparents who are primary caregivers for their grandchildren has also increased, which can negatively effects the grandparents’ physical and mental health, and increase social isolation and financial burden. However, the associations between grandparental caregiving and health outcomes are not well understood on a population level. Therefore, the purpose of this study was to assess associations between grandparental caregiving, socioeconomic status, and population health outcomes. Using mortality data (2009-2011) from the Rhode Island (RI) Department of Health and life table methods for each RI city/town, life expectancy at age 65 (LE65) and age-standardized mortality rates (ASMR) were calculated and linked to data from the American Community Survey on grandparental caregiving responsibilities, grandparental living arrangements (co-residence), poverty status, and demographics. Correlations and multivariable linear regression modeling were used to evaluate associations among LE65, ASMR, grandparental caregiving and co-residence, demographics, and poverty. Both LE65 (rho=-0.382, p=0.016) and ASMR (rho=0.327, p=0.042) were associated with the percent of grandparents living with grandchildren. The percent of grandparents as primary caregivers to their grandchildren was not significantly associated with LE65 or ASMR. ASMR was associated with the percent of grandparents living in poverty (rho=0.401, p=0.013) and overall poverty (rho=0.363, p=0.023). These results highlight conditions of community-based living and role of primary caregivers at an older age that should be further explored to improve the health of grandparents, particularly in multi-generational homes.

scholarly journals Burns from ignited household aerosols in the kitchen: a case series

2017 ◽  
Vol 3 ◽  
pp. 205951311772820 ◽  
Author(s):  
Anant Dinesh ◽  
Thais Polanco ◽  
Ryan Engdahl
Keyword(s):  
Hospital Admission ◽  
Daily Living ◽  
Burn Injury ◽  
Case Series ◽  
Upper Extremities ◽  
Heat Sources ◽  
Burn Patients ◽  
Gaseous Mixtures ◽  
Food Grade ◽  
Burn Unit

Aerosol sprays are commonly used products in daily living. Aerosols in kitchen products have prompted for use of ‘food grade’ or chemically inert propellants; however, they commonly contain gases or gaseous mixtures such as butane, propane and dimethyl ether that are flammable. When such sprays are used near heat sources, such as kitchen appliances, combustibles in these products can result in ignition and burn injury. Given the ubiquity of such sprays, surprisingly burns sustained from household aerosols are not characterised in the literature. We conducted a retrospective search of all burn patients treated at our hospital which contains a burn unit. Three patients were identified with burn wounds due to household aerosol sprays. All three occurred in the kitchen. and were characterized as first-degree and second-degree burns over the head and neck or upper extremities with one requiring inpatient admission. Where it may be perceived a cause of minor injury, household aerosol burns may result in significant burn injury and hospital admission. Household aerosols and burn injury are reviewed.

Impact of nicotine/smoking, alcohol, and illicit substance use on outcomes and complications of burn patients requiring hospital admission: systematic review and meta-analysis

Burns ◽  
2020 ◽  
Vol 46 (7) ◽  
pp. 1498-1524 ◽  
Author(s):  
Kevin M. Klifto ◽  
Pragna N. Shetty ◽  
Benjamin R. Slavin ◽  
Caresse F. Gurno ◽  
Stella M. Seal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Substance Use ◽  
Hospital Admission ◽  
Meta Analysis ◽  
Burn Patients ◽  
Illicit Substance ◽  
Illicit Substance Use

scholarly journals Clinical and Socioeconomic Differences in Methamphetamine-Positive Burn Patients

2019 ◽  
Vol 40 (6) ◽  
pp. 734-742
Author(s):  
Eve A Solomon ◽  
David G Greenhalgh ◽  
Soman Sen ◽  
Tina L Palmieri ◽  
Kathleen S Romanowski
Keyword(s):  
Socioeconomic Status ◽  
Skilled Nursing Facility ◽  
Inhalation Injury ◽  
Burn Patients ◽  
Lower Socioeconomic Status ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
Methamphetamine Use ◽  
Discharge Disposition ◽  
Lower Socioeconomic

Abstract Previous research on burn patients who test positive for methamphetamines (meth) has yielded mixed results regarding whether meth-positive status leads to worse outcomes and longer hospitalizations. We hypothesized that meth-positive patients at our regional burn center would have worse outcomes. We reviewed burn admissions from January 2014 to December 2017 and compared total patients versus meth-positive, and matched meth-negative versus meth-positive for total BSA burn, length of stay (LOS), intensive care unit (ICU) days, days on ventilator, discharge status (lived/died), number of operating room (OR) visits, number of procedures, socioeconomic status, comorbidities, and discharge disposition. Of 1363 total patients, 264 (19.4%) were meth-positive on toxicology screen. We matched 193 meth-positive patients with meth-negative controls based on TBSA burn, age, and inhalation injury. In the total population comparison, meth-positive patients had larger burns (15.6% vs 12.2%; P = .004), longer LOS (17.8 vs 14.3 days; P = .041), and fewer operations/TBSA (0.12 vs 0.2; P = .04), and lower socioeconomic status. Meth-positive patients were less likely to be discharged to a skilled nursing facility, and more likely to leave against medical advice. In the matched patients, we found no significant differences in LOS or OR visits/TBSA burn. Meth-positive patients have lower socioeconomic status, larger burns, and longer LOS compared to the total burn population. Methamphetamine use, by itself, does not appear to change outcomes. Methamphetamine use leads to larger burns in a population with fewer resources than the general population.

scholarly journals Cortisol and socioeconomic status in early childhood: A multidimensional assessment

2020 ◽  
Vol 32 (5) ◽  
pp. 1876-1887 ◽  
Author(s):  
Amanda R. Tarullo ◽  
Charu T. Tuladhar ◽  
Katie Kao ◽  
Eleanor B. Drury ◽  
Jerrold Meyer
Keyword(s):  
Socioeconomic Status ◽  
Early Childhood ◽  
Food Insecurity ◽  
Parent Education ◽  
Salivary Cortisol ◽  
Cortisol Concentration ◽  
Household Chaos ◽  
Multidimensional Assessment ◽  
Biological Stress ◽  
Neighborhood Risk

AbstractThe hypothalamic–pituitary–adrenal (HPA) axis is sensitive to early life stress, with enduring consequences for biological stress vulnerability and health (Gunnar & Talge, 2008). Low socioeconomic status (SES) is associated with dysregulation of the stress hormone cortisol in early childhood. However, a mechanistic understanding of this association is lacking. Multidimensional assessment of both SES and cortisol is needed to characterize the intricate relations between SES and cortisol function in early childhood. We assessed parent-reported family income, parent education, occupational prestige, neighborhood risk, food insecurity, and household chaos for 12-month-old infants (N = 90) and 3.5-year-old children (N = 91). Hair cortisol concentration (HCC) was obtained from parent and child, indexing chronic biological stress, and diurnal salivary cortisol was measured in the children. Controlling for parent HCC, parent education uniquely predicted infant and child HCC and, in addition, neighborhood risk uniquely predicted infant HCC. Household chaos predicted bedtime salivary cortisol concentration (SCC) for both infants and children, and infant daily cortisol output. Food insecurity was associated with flattened cortisol slope in 3.5-year-old children. Parental sensitivity did not mediate relations between SES and cortisol. Results highlight the utility of SES measures that index unpredictable and unsafe contexts, such as neighborhood risk, food insecurity, and household chaos.

scholarly journals Neighborhood Risk and Hospital Use for Pediatric Asthma, Rhode Island, 2005–2014

2019 ◽  
Vol 16 ◽  
Author(s):  
Annie Gjelsvik ◽  
Michelle L. Rogers ◽  
Aris Garro ◽  
Adam Sullivan ◽  
Daphne Koinis-Mitchell ◽  
...  
Keyword(s):  
Rhode Island ◽  
Pediatric Asthma ◽  
Neighborhood Risk ◽  
Hospital Use

scholarly journals Health Disparities Among People Infected With Influenza, Rhode Island, 2013-2018

2020 ◽  
Vol 135 (6) ◽  
pp. 771-777
Author(s):  
Kori Otero ◽  
Leonard A. Mermel
Keyword(s):  
High School ◽  
Socioeconomic Status ◽  
Health Disparities ◽  
Educational Attainment ◽  
Rhode Island ◽  
Household Income ◽  
Influenza Infection ◽  
Severe Infection ◽  
Socioeconomic Factor ◽  
Median Household Income

Objectives Health disparities are associated with poor outcomes related to public health. The objective of this study was to assess health disparities associated with influenza infection based on median household income and educational attainment. Methods We geocoded people with documented confirmed influenza infection by home address to identify the US Census 2010 tract in which they lived during 4 influenza surveillance seasons (2013-2014, 2015-2016, 2016-2017, and 2017-2018) in Rhode Island. We dichotomized influenza as severe if the person with influenza infection was hospitalized (ie, inpatient) or as nonsevere if the person was not hospitalized (ie, outpatient). We examined 2 socioeconomic factors: median household income (defined as low, medium low, medium high, and high) and educational attainment (defined as a ratio among people who completed <high school, high school, some college, or ≥bachelor’s degree). We calculated relative rates (RRs) to determine the associated level of risk for each socioeconomic factor. Results The incidence of influenza per 100 000 person-years was significantly higher in populations with low vs high median household income (620 vs 303; P < .001) and in populations with low vs high educational attainment (583 vs 323; P < .001). The RR of a severe infection in the quartile with the lowest educational attainment (0.57) was significantly higher than the RR in the other 3 quartiles of educational attainment (range, 0.36-0.39; P = .01). However, the RR of a severe infection was higher in the 3 quartiles of median household income (range, 0.38-0.40) than in the quartile with the lowest median household income (0.29). Conclusions People in Rhode Island with a lower socioeconomic status are at greater risk of an influenza infection than people with higher socioeconomic status. The reasons for these disparities require further investigation.

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