Tag Archives: income

Income and Health Outcomes in Pediatric Short Bowel Syndrome

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Clarification: Yesterday’s post on the safe use of polyethylene glycol (Long Term Use of Polyethylene Glycol (PEG 3350)) noted the labeling indicates “‘to not use these medications for more than 7 days.” However, Ben Enav pointed out that the label also states the following in bold: “do not take more than directed unless advised by your doctor.” The actual label is shown below.

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SA Gutierrez et al. J Pediatr 2024; 265: 113819. Neighborhood Income Is Associated with Health Care Use in Pediatric Short Bowel Syndrome

Methods: The authors used the Pediatric Health Information System (PHIS) database to evaluate associations between neighborhood income and hospitalization data for children with short bowel syndrome (SBS). This included 4289 children with 16,347 hospitalizations from 43 institutions.

Key findings:

  • 2153 of the 4289 (50%) patients were readmitted during the study period (2006-2015)
  • Children living in low-income neighborhoods were more likely to be Black, Hispanic, have public health insurance, and live in the Southern U.S.
  • Children from low-income neighborhoods had a 38% increased risk for all-cause hospitalizations (rate ratio [RR] 1.38), an 83% increased risk for CLABSI hospitalizations (RR 1.83) and increased hospital length of stay.
  • 2.4% of patients in this cohort experienced 10 or more CLABSI hospitalizations

One of the study’s limitations is that ‘there is no singular ICD-9 code for SBS.’

My take: It is speculation about the reasons why children in low income neighborhoods have higher rates of hospitalizations and CLABSI hospitalizations. It could be that more parents in these households have less time and resources to manage a child with SBS. It is possible that these households have more chaotic environments. Regardless of the reason, it takes a lot of work and meticulous care to prevent CLABSI hospitalizations in children with SBS.

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A lot of Turk’s Cap Cacti along the Ram Head Trail, St John

More on Breastfeeding and Intelligence

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A recent prospective study with 30 year followup indicates that breastfeeding is associated with improved IQ and income.

A summary of the study from NBC/Today Health.  An excerpt:

Babies who are breastfed for at least a year grow up to be significantly more intelligent as adults and they earn more money, too, a new study shows….

Many experts have questioned whether it’s breastfeeding that makes babies grow up healthier and smarter, or something else that their mothers do — maybe spending more time with them. In other studies done in the U.S. and Europe, mothers who breastfeed longer tend to be more educated and affluent — and that clearly has an effect on their kids.

This study was different.

“What is unique about this study is the fact that, in the population we studied, breastfeeding was not more common among highly educated, high-income women, but was evenly distributed by social class,” Horta said.

Coverage of story from NY Times with link to original study: an excerpt:

The study, in the April issue of Lancet Global Health, began in 1982 with 5,914 newborns. The duration of breast-feeding and the age when the babies began eating solid foods was recorded. Thirty years later, researchers were able to interview and test 3,493 of the original group….

Still, the authors acknowledge that this is an observational study, and that many other unmeasured factors could have influenced their results.

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