Researchers at Ann & Robert H. Lurie Children’s Hospital in Chicago found that children in under-resourced neighborhoods had increased odds of complicated appendicitis, an indicator of delayed access to surgical care.
The team at Lurie Children’s hospital analyzed more than 67,000 emergency appendectomies nationwide. They chose appendectomies because they are the most common emergency surgery performed on children.
Dr. Fizan Abdullah, Division Head of Pediatric Surgery at Lurie, said they account for 20 to 25 percent of the operations performed at the hospital.
Dr. Abdullah and the team found factors such as safety and housing had an impact on surgical care.
They looked at the "Child Opportunity Index," which combines data from 29 neighborhood-level indicators into one compositors measures.
COI varies greatly across the Chicago area as you can see on this map, with some area measuring "Very Low" and others measuring "Very High."
Lurie researchers found children living in locations with a low COI had up to 28 percent increased odds of complicated appendicitis.
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"So what that means is that children did not get access to care as quickly if they had more challenging social determinants of health," Dr. Abdullah said.
Dr. Hassan Ghomrawi, a co-author of the study that appears in the the journal JAMA Network Open, described what kind of social determinants were factors.
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"I'm talking about your access to transportation. I'm talking about your access to healthy foods. I'm talking about your access to education," Dr. Ghomrawi said.
Dr. Ghomrawi said the study affirms what previous research has already shown: where we live affects our health outcomes.
"That's mainly the purpose of the study, to add evidence to show that kids also are affected,” Dr. Ghomrawi said. "And as insurance companies and healthcare systems develop interventions that would they would take children into account as well."
Dr. Abdullah believes one game changer is technology, from telehealth to wearable devices that monitor complications post-surgery, something Lurie is studying with appendicitis patients.
"Once we have these types of technologies applied to children, regardless of socioeconomic status, I think that will help level the playing field," Dr. Abdullah said.
