Clinical Report: Impact of Race and Family Income on Health Outcomes in Pediatric Patients

Overview

This study evaluates the impact of race and family income on health outcomes in pediatric patients with antineutrophil cytoplasmic antibody–associated vasculitis (AAV).

Background

Understanding social determinants of health (SDoH) is crucial for addressing health disparities in pediatric populations, particularly those with chronic conditions like AAV. This study is significant as it is the first to utilize nationally representative data to assess disparities in health outcomes related to race and income in pediatric AAV patients.

Data Highlights

This study utilized data from the Kids’ Inpatient Database (KID) for the years 2016 and 2019, focusing on pediatric patients hospitalized with AAV.

Key Findings

• Hispanic race or ethnicity was independently associated with severe AAV disease and end-stage renal disease (ESRD).
• Lower household income was linked to significantly decreased odds of renal transplantation among patients with ESRD.
• A dose-dependent relationship was observed between income quartile and likelihood of renal transplantation, with an 85% increase in odds for each one-quartile increase in income.
• The study included the largest reported cohort of Black and Hispanic pediatric patients with AAV, representing 35% of the sample.
• Most adults with vasculitis reported unmet social needs, particularly financial insecurity, affecting healthcare access.

Clinical Implications

Healthcare providers should consider race and socioeconomic factors when assessing pediatric patients with AAV.

Conclusion

This study highlights the impact of race and family income on health outcomes in pediatric AAV patients.

Related Resources & Content

1. Valdovinos et al., Arthritis Care & Research, 2023 -- Race and Household Income Are Associated With Disease Outcomes in Pediatric Patients With Antineutrophil Cytoplasmic Antibody–Associated Vasculitis Hospitalized in the United States
2. Pediatric Cardiology — Socioeconomic Variations in Emergency Hospital Admissions and Clinical Outcomes for Pediatric Patients with Congenital Heart Disease
3. The ASCO Post — Improved Health Insurance Coverage, Access to Care May Lessen Racial/Ethnic Disparities in Childhood Cancer Survival
4. Clinical Rheumatology — Clinical Features of ANCA-Associated Vasculitides in Polish Patients: A Retrospective Study from the POLVAS Registry
5. Clinical Rheumatology — A Comprehensive Review of Potential Pharmacological Interventions for Nephritis in Pediatric Patients with IgA Vasculitis (HSP)
6. KDIGO 2024 Clinical Practice Guideline for the Management of Antineutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitis
7. EULAR recommendations for the management of ANCA-associated vasculitis: 2022 update
8. EULAR recommendations for the management of ANCA-associated vasculitis: 2022 update | Annals of the Rheumatic Diseases
9. Arthritis & Rheumatology
10. Rituximab versus Cyclophosphamide for ANCA-Associated Vasculitis | New England Journal of Medicine
11. Plasma Exchange and Glucocorticoids in Severe ANCA-Associated Vasculitis | New England Journal of Medicine
12. Avacopan for the Treatment of ANCA-Associated Vasculitis | New England Journal of Medicine
13. European consensus-based recommendations for the diagnosis and treatment of rare paediatric vasculitides - the SHARE initiative - PubMed
14. Update on antineutrophil cytoplasmic autoantibody vasculitis in children - PubMed
15. Race and Household Income Are Associated With Disease Outcomes in Pediatric Patients With Antineutrophil Cytoplasmic Antibody–Associated Vasculitis Hospitalized in the United States - Valdovinos - Arthritis Care & Research - Wiley Online Library
16. Race, Ethnicity, Sex, Gender, Socioeconomic Status, and Representativeness of Race and Ethnicity in ANCA Vasculitis Randomized Trials - PMC
17. Racial and ethnic inequities in the quality of paediatric care in the USA: a review of quantitative evidence - PubMed