Kids in low-opportunity areas more likely to visit ER
these programs,
● Percentage of adults who attend college, ● Access to health facilities, ● Access to healthy food, ● Proximity to toxic waste, ● Parks and open spaces, ● Unemployment and public assistance rates.
For the study, the researchers looked at areas across San Francisco. The study included more than 47,000 youths under 18 who visited an emergency department or urgent care center between 2007 and 2011.
Almost 40 percent of the kids seen in ERS or urgent care centers were seen for respiratory conditions.
Fifteen percent of those were diagnosed with asthma. More than a third of the children were seen for conditions that could usually be handled during a doctor visit.
About one-third of the visits were due to injury or trauma.
The researchers then looked to see what type of neighborhoods these children were growing up in.
They also compared low opportunity neighborhoods to those traditionally de¿ned as low income, based on US Census data.
While these areas often overlapped, areas of low opportunity covered more area.
Kersten said that this shows that when studies only look at an area’s income, they may miss people who need health care assistance.
Race and ethnicity played big roles in areas with low opportunity.
Kersten said, “More than three out of every four Africanamerican or Latino patients in our sample lived in a low opportunity neighborhood compared with just one out of every four white patients.
“And 82 percent of publicly insured patients lived in low opportunity neighborhoods, compared with 27 percent of privately insured patients.
“These disparities in neighborhood child opportunity translate into disparities in child health.
“Because each low opportunity neighborhood has different challenges, the reasons behind the increased ER and urgent care visits vary.”
And that means the solution to this problem will need to be individualized by community.
She said, “But could include investments in public schools and day cares, improving access to healthy food and parks, and expanding local hiring and housing assistance programs.”
Dr. Peter Richel, chief of pediatrics at Northern Westchester Hospital in Mount Kisco, NY, reviewed the ¿ndings.
He said, “Emergency departments are overutilized by those in the lower income brackets. It’s sad to me that not all children have a relationship with a primary care provider.
“While ER doctors are great and well-trained, they’re not ideal for routine care for children.
“They don’t know the patient’s history. They don’t follow them from newborn to 21, and ERS can be intimidating.
“It’s also not ideal from the health care side. It’s taxing to the facilities and it’s expensive to spend money on highly quali¿ed ER talent to sometimes treat a cold.”