The association between fracture rates and neighborhood characteristics in Washington, DC, children

摘要: Background Effects of neighborhood contextual features have been found for many diseases, including bone fractures in adults. Our study objective was to evaluate the association between characteristics and pediatric fracture rates. We hypothesized that indices deprivation would be associated with higher Materials Methods Pediatric cases treated at a tertiary, academic, urban emergency department 2003 2006 were mapped census block groups using geographical information systems software. Fracture rates calculated as per 1000 children each block. Exploratory factor analysis socioeconomic indicators performed 2000 data. Factor scores used predict odds individual level while adjusting mean age, sex composition, race/ethnicity composition our sample Results analyzed 3764 visits 3557 patients representing 349 distinct blocks groups. among ranged from 0 207 children/study period. Logistic regression modeling identified 2 factors (race/education large families) increased risk. Census variables reflecting African American race, laborer/service industry employment, long-term group residence, lower education levels strongly loaded on race/education factor. The families indicated children-to-families ratio within group. poverty not independently Conclusions Thus, are risk children. These results can help inform translational efforts develop targeted strategies prevention