Pediatric Emergency Care and Medicine: Open Access

Socio-Economic and Racial Disparities in Severity of Pediatric Pool Drownings

Objectives: Pediatric drownings are a leading cause of death in the United States. There are racial/ethnic and socioeconomic disparities in the incidence of swimming pool-related drownings in pediatric patients. This study measures racial/ethnic and socioeconomic disparities in severity of pediatric pool drownings.

Study Design: We performed a cohort study using the Pediatric Health Information System database from 2007 to 2017. Patients 0-19 years old with diagnosis codes of pool drownings were included. We used summary statistics to calculate the severity, measured by mortality, mechanical ventilation, intensive care unit admission, and hospital admission, of drownings. Multivariable logistic regression was used to measure the relative effect size of these factors on severity of drownings after adjusting for age, gender, urban location and geographic locations.

Results: There were 5923 pool drownings from 31 hospitals. Overall, 7.8% of children died, 18.5% required mechanical ventilation 29.4% required intensive care unit admission and 70% of children required hospitalization. Publicly insured children had higher odds of mortality (aOR 1.35; 1.01, 1.80), mechanical ventilation (aOR 1.36; 1.07, 1.73), intensive care unit admission (aOR 1.18; 1.00, 1.39), and hospitalization (aOR1.19; 1.00, 1.41) compared to those with private insurance. Children in the lowest income quintile (<$32,516) had higher odds of mortality (aOR 1.69; 1.23, 2.34) and mechanical ventilation (aOR 1.59; 1.11, 2.28) when compared to the highest income quintile (>$61,078).

Conclusion: Children who are publicly insured and from lower income quintiles experience more severe pool drownings. Race/ethnicity was not associated with increased severity of pool drownings in children.

Author(s):

Nancy Prem, Gia M Badolato, and Joanna S Cohen

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