{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T02:33:44Z","timestamp":1768703624523,"version":"3.49.0"},"reference-count":38,"publisher":"BMJ","issue":"5","funder":[{"name":"National Institute of Mental Health, National Institute of Health","award":["K08 MH129657"],"award-info":[{"award-number":["K08 MH129657"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Inj Prev"],"accepted":{"date-parts":[[2024,12,8]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Community context influences children\u2019s risk for injury. We aimed to measure the explanatory capacity of two ZIP code-level measures\u2014the Child Opportunity Index V.3.0 (COI) and median household income (MHHI)\u2014for rates of paediatric injury hospitalisations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>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 &lt;5 years, injuries suspicious for abuse among infants &lt;12 months and unintentional injuries among children &lt;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\u2019 education, health and environment and social and economic characteristics. We used pseudo R<jats:sup>2<\/jats:sup> values from Poisson regression models to describe the per cent of variance in rates of each injury category explained by the COI and MHHI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/ip-2024-045423","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T13:20:36Z","timestamp":1737033636000},"page":"428-434","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Explanatory capacity of measures of community context for paediatric injury hospitalisations in the USA"],"prefix":"10.1136","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5436-7965","authenticated-orcid":false,"given":"Henry T","family":"Puls","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA"},{"name":"University of Missouri\u2014Kansas City School of Medicine, Kansas City, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clemens","family":"Noelke","sequence":"additional","affiliation":[{"name":"The Heller School of Social Policy and Management, Institute for Child, Youth, and Family Policy, Brandeis University, Waltham, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristyn N","family":"Jeffries","sequence":"additional","affiliation":[{"name":"University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA"},{"name":"Department of Pediatrics, Arkansas Children's Hospital, Little Rock, Arkansas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel M","family":"Lindberg","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA"},{"name":"Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, Department of Pediatrics, Children's Hospital of Colorado, Aurora, Colorado, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna E","family":"Austin","sequence":"additional","affiliation":[{"name":"Department of Maternal and Child Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara H","family":"Chaiyachati","sequence":"additional","affiliation":[{"name":"Policy Lab, Clinical Futures, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA"},{"name":"Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Hall","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA"},{"name":"Children's Hospital Association, Lenexa, Kansas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,1,16]]},"reference":[{"key":"2025092602555233000_31.5.428.1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2020.00735"},{"key":"2025092602555233000_31.5.428.2","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2019.19928","article-title":"Quantification of Neighborhood-Level Social Determinants of Health in the Continental United States","volume":"3","author":"Kolak","year":"2020","journal-title":"JAMA Netw Open"},{"key":"2025092602555233000_31.5.428.3","doi-asserted-by":"crossref","DOI":"10.1186\/s40621-016-0097-0","article-title":"An overview of geospatial methods used in unintentional injury epidemiology","volume":"3","author":"Singh","year":"2016","journal-title":"Inj Epidemiol"},{"key":"2025092602555233000_31.5.428.4","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2023-063411","article-title":"Trends in Pediatric Nonfatal and Fatal Injuries","volume":"152","author":"Mannix","year":"2023","journal-title":"Pediatrics"},{"key":"2025092602555233000_31.5.428.5","doi-asserted-by":"publisher","DOI":"10.1136\/injuryprev-2014-041444"},{"key":"2025092602555233000_31.5.428.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsr.2017.12.017"},{"key":"2025092602555233000_31.5.428.7","doi-asserted-by":"crossref","first-page":"e39","DOI":"10.1093\/pch\/pxz145","article-title":"Childhood unintentional injury: The impact of family income, education level, occupation status, and other measures of socioeconomic status. 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