{
  "abstract": "Objective Community context influences children’s risk for injury. We aimed to measure the explanatory capacity of two ZIP code-level measures—the Child Opportunity Index V.3.0 (COI) and median household income (MHHI)—for rates of paediatric injury hospitalisations.Methods This was a retrospective cross-sectional population-based study of children living in 19 US states in 2017. We examined injury hospitalisation rates for three categories: physical abuse among children <5 years, injuries suspicious for abuse among infants <12 months and unintentional injuries among children <18 years. Hospitalisation counts were obtained from the Healthcare Cost and Utilization Project and population data from the US Census. The COI is a multidimensional measure of communities’ education, health and environment and social and economic characteristics. We used pseudo R 2 values from Poisson regression models to describe the per cent of variance in rates of each injury category explained by the COI and MHHI.Results The COI explained 75.4% of the variability in rates of physical abuse, representing a 13.5% improvement over MHHI. The COI explained 58.5% of the variability in injuries suspicious for abuse, a 20.7% improvement over MHHI. The COI and MHHI explained 85.7% and 85.8% of the variability in unintentional injuries, respectively; results differed when unintentional injuries were stratified by mechanism and age.Implications The COI had superior explanatory capacity for physical abuse and injuries suspicious for abuse compared with MHHI and was similar for unintentional injury hospitalisations. COI represents a means of accounting for community advantage in paediatric injury data, research and prevention.",
  "authors": [
    {
      "affiliations": [
        "Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA",
        "University of Missouri—Kansas City School of Medicine, Kansas City, Missouri, USA"
      ],
      "name": "Henry T Puls"
    },
    {
      "affiliations": [
        "The Heller School of Social Policy and Management, Institute for Child, Youth, and Family Policy, Brandeis University, Waltham, Massachusetts, USA"
      ],
      "name": "Clemens Noelke"
    },
    {
      "affiliations": [
        "University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA",
        "Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas, USA"
      ],
      "name": "Kristyn N Jeffries"
    },
    {
      "affiliations": [
        "Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA",
        "Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Department of Pediatrics, Children's Hospital of Colorado, Aurora, Colorado, USA"
      ],
      "name": "Daniel M Lindberg"
    },
    {
      "affiliations": [
        "Department of Maternal and Child Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"
      ],
      "name": "Anna E Austin"
    },
    {
      "affiliations": [
        "Policy Lab, Clinical Futures, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA",
        "Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA"
      ],
      "name": "Barbara H Chaiyachati"
    },
    {
      "affiliations": [
        "Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA",
        "Children's Hospital Association, Lenexa, Kansas, USA"
      ],
      "name": "Matthew Hall"
    }
  ],
  "title": "Explanatory capacity of measures of community context for paediatric injury hospitalisations in the USA",
  "uid": "c1a07ef7-1018-5c08-85b9-fab928a8b5e9"
}