Social determinants of health at a pediatric age in a hospital setting: a systematic review

Authors

  • Mário André Macedo Enfermeiro, Mestre em Saúde Pública, Especialista em Saúde Infantil e Pediátrica. Urgência Pediátrica, Hospital Fernando Fonseca. Amadora, Portugal.

DOI:

https://doi.org/10.25758/set.1981

Keywords:

Health inequalities, Social determinants of health, Pediatrics

Abstract

Introduction – Health inequalities are recognized as a public health problem. The relationship between social determinants and health inequalities is a robust finding. While in adulthood, these socioeconomic inequalities become manifest in terms of general health status, the situation is less clear in childhood and adolescence in a hospital setting. It was then undertaken a systematic in order to contribute towards a better knowledge of the subject. Methods – Based on the PRISMA guidelines, the following MeSH terms were used: ‘social class’, ‘pediatric’, ‘hospital’, ‘emergency treatment’, ‘socioeconomic factor’, and ‘healthcare disparities’. The search was performed on articles published between 1 January 2000 and 31 August 2016, on PubMed, MEDLINE, and on the database from Cochrane. Review and opinion articles were excluded, as well as articles dealing with issues of access to healthcare. It was performed a qualitative and quantitative description of the results. Results – Seventeen publications were selected all reporting observational analyses, most of the using retrospective data. These publications showed strong evidence for health inequalities, such as the length of stay or severity of illness upon admission to the intensive care unit, and the social determinants of health in the pediatric age in a hospital setting. Conclusions – Although the same relationship has already been demonstrated in a community setting, it is necessary to elaborate on more studies that relate socioeconomic status and health inequalities in a hospital context. It is important to deepen the studies in these areas, in order to identify the most significant social determinants and vulnerable populations, to better plan health care, and tackle the health inequalities.

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References

Marmot M, Friel S, Bell R, Houweling TA, Taylor S. Closing the gap in a generation: health equity through action on the social determinants of health. Lancet. 2008;372(9650):1661-9.

WHO. About social determinants of health [website]. Geneva: WHO; 2015 [cited 2016 Jul 15]. Available from: http://www.who.int/social_determinants/sdh_definition/en/

Loureiro I, Miranda N. Promover a saúde: dos fundamentos à acção. Coimbra: Almedina; 2010. ISBN 9789724043999

Organização Mundial da Saúde. Declaração política do Rio sobre determinantes sociais da saúde [Internet]. Rio de Janeiro: OMS; 2011. Available from: https://www.who.int/sdhconference/declaration/Rio_political_declaration_portuguese.pdf

World Health Organization. Portugal health system performance assessment 2010. Copenhagen; WHO Regional Office for Europe; 2010.

Geyer S, Peter R, Siegrist J. Socioeconomic differences in children’s and adolescents’ hospital admissions in Germany: a report based on health insurance data on selected diagnostic categories. J Epidemiol Community Health. 2002;56(2):109-14.

Starfield B. Social gradients and child health. In: Heggenhougen HK, editor. International encyclopedia of public health. Amsterdam: Elsevier; 2008. p. 87-101. ISBN 9780123739605

West P, Sweeting H. Evidence on equalisation in health in youth from the West of Scotland. Soc Sci Med. 2004;59(1):13-27.

West P. Health inequalities in the early years: Is there equalisation in youth? Soc Sci Med. 1997;44(6):833-58.

Campos-Matos I, Russo G, Perelman J. Connecting the dots on health inequalities: a systematic review on the social determinants of health in Portugal. Int J Equity Health. 2016;15:26.

Nogueira H, Ferrão M, Gama A, Mourão I, Rosado Marques V, Padez C. Perceptions of neighborhood environments and childhood obesity: evidence of harmful gender inequities among Portuguese children. Health Place. 2013;19:69-73.

Costa C, Ramos E, Severo M, Barros H, Lopes C. Determinants of eating disorders symptomatology in Portuguese adolescents. Arch Pediatr Adolesc Med. 2008;162(12):1126-32.

Mello T, Antunes J, Waldman E, Ramos E, Relvas M, Barros H. Prevalence and severity of dental caries in schoolchildren of Porto, Portugal. Community Dent Health. 2008;25(2):119-25.

Correia S, Barros H. Small-for-gestational age Portuguese babies: the effect of childhood social environment, growth and adult socioeconomic conditions. Prev Med. 2015;70:102-7.

Cristina A, Alves J, Perelman J. Desigualdades socioeconómicas no tabagismo em jovens dos 15 aos 17 anos [Socioeconomic inequalities in smoking among adolescents aged from 15‐17]. Rev Port Saúde Pública. 2016;34(1):69-76. Portuguese

Ikefuna AN, Emodi IJ. Some characteristics of paediatric admissions at the University of Nigeria Teaching Hospital Enugu-Nigeria. Niger J Clin Pract. 2007;10(3):216-9.

Xie J, Lin Y, Kissoon N. Factors associated with prolonged stay in a pediatric emergency observation unit of an urban tertiary children's hospital in China. Pediatr Emerg Care. 2013;29(2):183-90.

Colvin JD, Zaniletti I, Fieldston ES, Gottlieb LM, Raphael JL, Hall M, Cowden JD, et al. Socioeconomic status and in-hospital pediatric mortality. Pediatrics. 2013;131(1):e182-90.

Dy CJ, Lyman S, Do HT, Fabricant PD, Marx RG, Green DW. Socioeconomic factors are associated with frequency of repeat emergency department visits for pediatric closed fractures. J Pediatr Orthop. 2014;34(5):548-51.

Beck AF, Simmons JM, Huang B, Kahn RS. Geomedicine: area-based socioeconomic measures for assessing risk of hospital reutilization among children admitted for asthma. Am J Public Health. 2012;102(12):2308-14.

Seif AE, Fisher BT, Li Y, Torp K, Rheam DP, Huang YS, et al. Patient and hospital factors associated with induction mortality in acute lymphoblastic leukemia. Pediatr Blood Cancer. 2014;61(5):846-52.

Epstein D, Reibel M, Unger JB, Cockburn M, Escobedo LA, Kale DC, et al. The effect of neighborhood and individual characteristics on pediatric critical illness. J Community Health. 2014;39(4):753-9.

Szynkaruk M, Stephens D, Borschel GH, Wright JG. Socioeconomic status and wait times for pediatric surgery in Canada. Pediatrics. 2014;134(2):e504-11.

Roberts CA, Bernard MC. Tuberculosis: a biosocial study of admissions to a children’s sanatorium (1936-1954) in Stannington, Northumberland, England. Tuberculosis (Edinb). 2015;95 Suppl 1:S105-8.

Zook HG, Kharbanda AB, Flood A, Harmon B, Puumala SE, Payne NR. Racial differences in pediatric emergency department triage scores. J Emerg Med. 2016;50(5):720-7.

Sedaghat AR, Cunningham MJ, Ishman SL. Regional and socioeconomic disparities in emergency department use of radiographic imaging for acute pediatric sinusitis. Am J Rhinol Allergy. 2014;28(1):23-8.

Wang L, Haberland C, Thurm C, Bhattacharya J, Park KT. Health outcomes in US children with abdominal pain at major emergency departments associated with race and socioeconomic status. PLoS One. 2015;10(8):e0132758.

Dyer AA, Lau CH, Smith TL, Smith BM, Gupta RS. Pediatric emergency department visits and hospitalizations due to food-induced anaphylaxis in Illinois. Ann Allergy Asthma Immunol. 2015;115(1):56-62.

Colvin JD, Zaniletti I, Fieldston ES, Gottlieb LM, Raphael JL, Hall M, et al. Socioeconomic status and in-hospital pediatric mortality. Pediatrics. 2013;131(1):e182-90.

Falcone RA Jr, Brown RL, Garcia VF. The epidemiology of infant injuries and alarming health disparities. J Pediatr Surg. 2007;42(1):172-7.

Gallagher RA, Porter S, Monuteaux MC, Stack AM. Unscheduled return visits to the emergency department: the impact of language. Pediatr Emerg Care. 2013;29(5):579-83.

Harrison B, Finkelstein M, Puumala S, Payne NR. The complex association of race and leaving the pediatric emergency department without being seen by a physician. Pediatr Emerg Care. 2012;28(11):1136-45.

Furtado C, Pereira J. Equidade e acesso aos cuidados de saúde [Internet]. Lisboa: Escola Nacional de Saúde Pública; 2010. Available from: http://1nj5ms2lli5hdggbe3mm7ms5.wpengine.netdna-cdn.com/files/2010/08/EA1.pdf

Direção-Geral da Saúde. Plano nacional de saúde: revisão e extensão a 2020. Lisboa: DGS; 2015.

Pereira J, Furtado C. Equidade em saúde: do conhecimento à acção. In: Escola Nacional de Saúde Pública, Direção-Geral da Saúde, editors. A nova saúde pública: a saúde pública na era do conhecimento. Lisboa: Gradiva; 2011. p. 52-7. ISBN 9789896164287

Published

2022-08-01

Issue

Section

Artigos de Revisão

How to Cite

Social determinants of health at a pediatric age in a hospital setting: a systematic review. (2022). Saúde & Tecnologia, 20, 44-52. https://doi.org/10.25758/set.1981