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

The Journal of Pediatrics
Jeffrey P YaegerGina S Lovasi

Abstract

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 infa...Continue Reading

Citations

Apr 3, 2019·Hospital Pediatrics·Shaunte McKay, Victoria Parente
Jan 10, 2020·Hospital Pediatrics·Timothy M KloudaJeffrey P Yaeger
Jan 10, 2021·The Journal of Pediatrics·Jeffrey P YaegerKevin Fiscella

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