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Associations of Neighborhood-Level Social Determinants of Health with Bacterial Infections in Young, Febrile Infants
Journal article   Peer reviewed

Associations of Neighborhood-Level Social Determinants of Health with Bacterial Infections in Young, Febrile Infants

Jeffrey P. Yaeger, Kari A. Moore, Steven J. Melly and Gina S. Lovasi
The Journal of pediatrics, v 203, pp 336-344
Dec 2018
DOI: https://doi.org/10.1016/j.jpeds.2018.08.020
PMID: 30244985
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

geographic information system analysis health disparities public health
To examine the sociodemographic characteristics of one population of young, febrile infants and identify associations between neighborhood-level social determinants of health (SDHs) with bacterial infections. This was a retrospective cross sectional study of all infants ≤90 days old with a temperature of ≥38°C who presented in 2014 to the emergency department of an urban children's hospital in a large east coast city. The primary outcome was the presence of a bacterial infection, defined as a positive urine, blood, or cerebrospinal fluid culture that was treated clinically as a pathogen. The home address of each infant was geocoded and linked to neighborhood data based on census tract. Neighborhood-level SDHs included deprivation index, median household income, poverty, childhood poverty, social capital, and crowded housing. Associations were estimated using generalized estimating equations and negative binomial regression analysis. Models were adjusted for age, prematurity, and race/ethnicity. Of 232 febrile infants, the median age was 54 days, 58% were male, 49% were Hispanic, and 88% had public health insurance; 31 infants (13.4%) had a bacterial infection. In the adjusted analyses, the risk of bacterial infection among infants from neighborhoods with high rates of childhood poverty was >3 times higher (relative risk, 3.16; 95% CI, 1.04-9.6) compared with infants from neighborhoods with low rates of childhood poverty. Our findings suggest that SDHs may be associated with bacterial infections in young, febrile infants. If confirmed in subsequent studies, the inclusion of SDHs in predictive tools may improve accuracy in detecting bacterial infections among young, febrile infants.

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20 citations in Web of Science
22 citations in Scopus

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UN Sustainable Development Goals (SDGs)

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Pediatrics
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