Pediatric emergency medicine physician Joanna Cohen discusses her latest publication “A Call to Action: Addressing Socioeconomic Disparities in Childhood Unintentional Injury Risk.” In this study, researchers address how the risk of preventable injury is not equal for everyone and how social, geographic and biological factors intersect with access to injury prevention services. Click here to read this publication.
Unintentional injuries are the leading cause of pediatric morbidity and mortality. After years of decreasing deaths in the United States, there has been the greatest surge in childhood mortality in the past decade, largely attributable to increased deaths from preventable injury. The risk of preventable injury is not equal for all individuals. Most importantly, the impact of structural racism on disparities in injuries, particularly in Children cannot be underestimated. Recognizing these disparities as unacceptable and advocating for changes in legislation, infrastructure investment, education and health care to address structural racism is necessary to improve health equity around socio-economic disparities. In this commentary, we describe how socio-economic inequities contribute to discrepant, unintentional injury risks and call for an expansion of investment and innovative and targeted injury prevention strategies to narrow this disparity. There is a significant impact of poverty on injury prevention treatment and outcome. For instance, a child living in poverty is more likely to live in a rental home or a home belonging to a friend or a family member and may not be able to easily make safety modifications like reducing the water heater's maximum temperature setting. People living in poverty are not only more likely to experience injuries, but those injuries are more likely to be severe. For instance, people experiencing poverty are more likely to experience residential fires and to suffer more severe burns and associated inhalation injuries as a result. And even after an injury, the impact of miss work to care for an injured child may lead to lost wages, disproportionately affecting those at highest risk for developing new or worsening food and or housing insecurity. While providing safety equipment to families in health care settings is possible. It can pose an array of challenges. Whereas coupling safety education with provisions has proven feasible and successful across a wide range of injury prevention interventions. A variety of small scale innovative models to improve uptake of preventive interventions have been successfully trialed including home visit programs, mobile safety centers and clinic based kiosks. Future directions could take the form of virtual safety centers integrated into the electronic health record, allowing providers to place orders using the same ordering system employed for vaccines and medications. Alternatively, a centralized web platform could serve as a one stop shop for hospital systems where coupled with access to safety product delivery services, video conference technologies could be used to connect patients to safety experts. Additionally, with the assistance of electronic medical records, spatial analysis and geo mapping data can be used to identify injury clusters and inform the most impactful interventions locally and regionally. Finally, modifications to physical environments such as repairing sidewalks, adding crosswalks and building neighborhood parks can impact injury risk. This is our call to action advocacy groups should influence policy change to expand federal and state funding for targeted injury prevention efforts that reflect the disproportionate risk severity and impact of injury on Children living in poverty. With an eye towards health equity, federal and state programs should expand health coverage of necessary provisions focused on installation and home adaptions to reduce financial and systemic barriers to the implementation of injury prevention modifications, providers and health care organizations should pursue creative technologically advanced solutions that can reduce socio-economic disparities in injury risk. Community organizations can expand the reach and impact of injury prevention programs that are tailored towards specific communities. And finally, local governments and housing agencies should prioritize investments in environmental and structural modifications to low income neighborhoods as an injury prevention strategy. In conclusion, investments in comprehensive individualized and innovative c childhood injury prevention programs coupled with neighborhood improvements to address environmental conditions that put Children experiencing poverty at risk for injury are possible and can narrow socio-economic gaps in injury prevention. I want to thank my co-author and my colleagues at the Children's Center. Thank you.
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