Area-Level Indices and Health Care Use in a Pediatric Brain and Central Nervous System Tumor Cohort: Observational Study
Abstract BackgroundWhile survival among pediatric patients with cancer has advanced, disparities persist. Public health tools such as the Area Deprivation Index, the Child Opportunity Index (COI), and the Social Vulnerability Index (SVI) are potential proxies for social determ...
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JMIR Publications
2025-05-01
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| Series: | JMIR Public Health and Surveillance |
| Online Access: | https://publichealth.jmir.org/2025/1/e66834 |
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| author | Yvette H Tran Seho Park Scott L Coven Eneida A Mendonca |
| author_facet | Yvette H Tran Seho Park Scott L Coven Eneida A Mendonca |
| author_sort | Yvette H Tran |
| collection | DOAJ |
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Abstract
BackgroundWhile survival among pediatric patients with cancer has advanced, disparities persist. Public health tools such as the Area Deprivation Index, the Child Opportunity Index (COI), and the Social Vulnerability Index (SVI) are potential proxies for social determinants of health and could help researchers, public health practitioners, and clinicians identify neighborhoods or populations most likely to experience adverse outcomes. However, evidence regarding their relationship with health care use, especially in the pediatric population with cancer, remains mixed.
ObjectiveWe sought to evaluate the relationship between emergency department (ED) visits and hospitalizations with these area-level indices in our study population.
MethodsWe conducted a cross-sectional study of pediatric patients with brain and central nervous system tumors in a single Midwestern state who were diagnosed between 2010 and 2020. We fitted zero-inflated Poisson models for counts of ED and inpatient visits to determine if any of these use measures were associated with our 3 area-level indices. Finally, we mapped index quintiles onto neighborhoods to visualize and compare how each index differentially ranks neighborhoods.
ResultsOur study cohort consisted of 524 patients; 78.6% (n=412) of them had no recorded ED visit, and 39.7% (n=208) had no record of hospitalization. Moderate (coefficient=0.306; PPPP
ConclusionsAlthough indices provide useful context about the environment in which our patient population resides in, we found little evidence that neighborhood conditions as measured by these indices consistently or reliably relate to health care use. |
| format | Article |
| id | doaj-art-6078deea7ea54710b06e14af2fafb0fd |
| institution | DOAJ |
| issn | 2369-2960 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Public Health and Surveillance |
| spelling | doaj-art-6078deea7ea54710b06e14af2fafb0fd2025-08-20T03:09:12ZengJMIR PublicationsJMIR Public Health and Surveillance2369-29602025-05-0111e66834e6683410.2196/66834Area-Level Indices and Health Care Use in a Pediatric Brain and Central Nervous System Tumor Cohort: Observational StudyYvette H Tranhttp://orcid.org/0000-0003-2997-4944Seho Parkhttp://orcid.org/0000-0002-4750-1916Scott L Covenhttp://orcid.org/0000-0003-2763-7928Eneida A Mendoncahttp://orcid.org/0000-0003-4297-9221 Abstract BackgroundWhile survival among pediatric patients with cancer has advanced, disparities persist. Public health tools such as the Area Deprivation Index, the Child Opportunity Index (COI), and the Social Vulnerability Index (SVI) are potential proxies for social determinants of health and could help researchers, public health practitioners, and clinicians identify neighborhoods or populations most likely to experience adverse outcomes. However, evidence regarding their relationship with health care use, especially in the pediatric population with cancer, remains mixed. ObjectiveWe sought to evaluate the relationship between emergency department (ED) visits and hospitalizations with these area-level indices in our study population. MethodsWe conducted a cross-sectional study of pediatric patients with brain and central nervous system tumors in a single Midwestern state who were diagnosed between 2010 and 2020. We fitted zero-inflated Poisson models for counts of ED and inpatient visits to determine if any of these use measures were associated with our 3 area-level indices. Finally, we mapped index quintiles onto neighborhoods to visualize and compare how each index differentially ranks neighborhoods. ResultsOur study cohort consisted of 524 patients; 78.6% (n=412) of them had no recorded ED visit, and 39.7% (n=208) had no record of hospitalization. Moderate (coefficient=0.306; PPPP ConclusionsAlthough indices provide useful context about the environment in which our patient population resides in, we found little evidence that neighborhood conditions as measured by these indices consistently or reliably relate to health care use.https://publichealth.jmir.org/2025/1/e66834 |
| spellingShingle | Yvette H Tran Seho Park Scott L Coven Eneida A Mendonca Area-Level Indices and Health Care Use in a Pediatric Brain and Central Nervous System Tumor Cohort: Observational Study JMIR Public Health and Surveillance |
| title | Area-Level Indices and Health Care Use in a Pediatric Brain and Central Nervous System Tumor Cohort: Observational Study |
| title_full | Area-Level Indices and Health Care Use in a Pediatric Brain and Central Nervous System Tumor Cohort: Observational Study |
| title_fullStr | Area-Level Indices and Health Care Use in a Pediatric Brain and Central Nervous System Tumor Cohort: Observational Study |
| title_full_unstemmed | Area-Level Indices and Health Care Use in a Pediatric Brain and Central Nervous System Tumor Cohort: Observational Study |
| title_short | Area-Level Indices and Health Care Use in a Pediatric Brain and Central Nervous System Tumor Cohort: Observational Study |
| title_sort | area level indices and health care use in a pediatric brain and central nervous system tumor cohort observational study |
| url | https://publichealth.jmir.org/2025/1/e66834 |
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