{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T13:35:45Z","timestamp":1783776945146,"version":"3.55.0"},"reference-count":25,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,4,1]]},"abstract":"<jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>A National Spina Bifida Patient Registry (NSBPR) was begun in 2009 to help understand the natural history of spina bifida (SB) and the effects of treatments provided by SB clinics. We used the NSBPR to explore the relationship of sociodemographic characteristics with SB outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>Using NSBPR data collected in 2009 to 2012, we examined the unadjusted association between demographic characteristics and 4 SB outcomes: bowel continence, bladder continence, mobility, and presence of pressure sores. We then developed multivariable logistic models to explore these relationships while controlling for SB clinic, SB type, and level of lesion.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>Data were available on 2054 patients &amp;lt;22 years of age from 10 SB clinics. In the multivariable models, older age groups were more likely to have continence and pressure sores and less likely to be community ambulatory. Males and patients without private insurance were less likely to be continent and community ambulatory. Non-Hispanic blacks were less likely to be continent. Level of lesion was associated with all outcomes; SB type was associated with all but pressure sores; and all outcomes except community ambulation showed significant variation across clinic sites.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Sociodemographic attributes are associated with SB outcomes. In particular, males, non-Hispanic blacks, and patients without private insurance have less favorable outcomes, and age has an impact as well. These characteristics need to be considered by clinicians who care for this patient population and factored into case-mix adjustment when evaluating variation in clinical and functional outcomes among different SB clinics.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2014-2576","type":"journal-article","created":{"date-parts":[[2015,3,17]],"date-time":"2015-03-17T00:48:40Z","timestamp":1426553320000},"page":"e957-e964","source":"Crossref","is-referenced-by-count":71,"title":["Sociodemographic Attributes and Spina Bifida Outcomes"],"prefix":"10.1542","volume":"135","author":[{"given":"Michael S.","family":"Schechter","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia;"},{"name":"Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiebin","family":"Liu","sequence":"additional","affiliation":[{"name":"Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minn","family":"Soe","sequence":"additional","affiliation":[{"name":"Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Swanson","sequence":"additional","affiliation":[{"name":"Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Ward","sequence":"additional","affiliation":[{"name":"Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia; and"},{"name":"Carter Consulting, Inc, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy","family":"Thibadeau","sequence":"additional","affiliation":[{"name":"Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2015,4,1]]},"reference":[{"issue":"3","key":"2021120907042118500_B1","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1159\/000056005","article-title":"Spina bifida outcome: a 25-year prospective.","volume":"34","author":"Bowman","year":"2001","journal-title":"Pediatr Neurosurg"},{"issue":"3","key":"2021120907042118500_B2","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1097\/MOP.0b013e328339550e","article-title":"Improving the quality of care for patients with cystic fibrosis.","volume":"22","author":"Schechter","year":"2010","journal-title":"Curr Opin Pediatr"},{"issue":"1","key":"2021120907042118500_B3","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1002\/bdra.23094","article-title":"Testing the feasibility of a National Spina Bifida Patient Registry.","volume":"97","author":"Thibadeau","year":"2013","journal-title":"Birth Defects Res A Clin Mol Teratol"},{"issue":"22","key":"2021120907042118500_B4","doi-asserted-by":"crossref","first-page":"2879","DOI":"10.1001\/jama.294.22.2879","article-title":"Socioeconomic status in health research: one size does not fit all.","volume":"294","author":"Braveman","year":"2005","journal-title":"JAMA"},{"issue":"2","key":"2021120907042118500_B5","first-page":"iii26","article-title":"Disentangling race and socioeconomic status: a key to understanding health inequalities.","volume":"82","author":"LaVeist","year":"2005","journal-title":"J Urban Health"},{"key":"2021120907042118500_B6","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/j.1749-6632.2009.05337.x","article-title":"Health disparities across the lifespan: meaning, methods, and mechanisms.","volume":"1186","author":"Adler","year":"2010","journal-title":"Ann N Y Acad Sci"},{"issue":"6","key":"2021120907042118500_B7","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1016\/j.jpeds.2008.09.011","article-title":"Patient registry analyses: seize the data, but caveat lector.","volume":"153","author":"Schechter","year":"2008","journal-title":"J Pediatr"},{"issue":"11","key":"2021120907042118500_B8","doi-asserted-by":"crossref","first-page":"1674","DOI":"10.2105\/AJPH.88.11.1674","article-title":"Socioeconomic status, neighborhood social conditions, and neural tube defects.","volume":"88","author":"Wasserman","year":"1998","journal-title":"Am J Public Health"},{"issue":"2","key":"2021120907042118500_B9","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1093\/aje\/kwm283","article-title":"Socioeconomic status in relation to selected birth defects in a large multicentered US case-control study.","volume":"167","author":"Yang","year":"2008","journal-title":"Am J Epidemiol"},{"issue":"9","key":"2021120907042118500_B10","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1093\/jpepsy\/jsq001","article-title":"Associations of ethnicity and SES with IQ and achievement in spina bifida meningomyelocele.","volume":"35","author":"Swartwout","year":"2010","journal-title":"J Pediatr Psychol"},{"key":"2021120907042118500_B11","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1146\/annurev.publhealth.18.1.341","article-title":"Measuring social class in US public health research: concepts, methodologies, and guidelines.","volume":"18","author":"Krieger","year":"1997","journal-title":"Annu Rev Public Health"},{"issue":"2","key":"2021120907042118500_B12","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1097\/TP.0b013e31827191d4","article-title":"Disparities among Blacks, Hispanics, and Whites in time from starting dialysis to kidney transplant waitlisting.","volume":"95","author":"Joshi","year":"2013","journal-title":"Transplantation"},{"issue":"6","key":"2021120907042118500_B13","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1164\/ajrccm.163.6.9912100","article-title":"The association of socioeconomic status with outcomes in cystic fibrosis patients in the United States.","volume":"163","author":"Schechter","year":"2001","journal-title":"Am J Respir Crit Care Med"},{"issue":"4","key":"2021120907042118500_B14","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.3390\/ijerph10041312","article-title":"Food fortification and decline in the prevalence of neural tube defects: does public intervention reduce the socioeconomic gap in prevalence?","volume":"10","author":"Agha","year":"2013","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"2021120907042118500_B15","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1542\/peds.91.1.56","article-title":"Childhood asthma and poverty: differential impacts and utilization of health services.","volume":"91","author":"Halfon","year":"1993","journal-title":"Pediatrics"},{"issue":"5","key":"2021120907042118500_B16","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1016\/j.jpeds.2009.04.059","article-title":"Association of socioeconomic status with the use of chronic therapies and healthcare utilization in children with cystic fibrosis.","volume":"155","author":"Schechter","year":"2009","journal-title":"J Pediatr"},{"issue":"2","key":"2021120907042118500_B17","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/S0749-3797(18)30353-2","article-title":"Associations between measures of socioeconomic status and maternal health behavior.","volume":"12","author":"Gazmararian","year":"1996","journal-title":"Am J Prev Med"},{"issue":"2","key":"2021120907042118500_B18","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.acap.2012.01.001","article-title":"Perceived barriers to care and attitudes towards shared decision-making among low socioeconomic status parents: role of health literacy.","volume":"12","author":"Yin","year":"2012","journal-title":"Acad Pediatr"},{"issue":"2","key":"2021120907042118500_B19","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1542\/peds.2012-0469","article-title":"The science of early life toxic stress for pediatric practice and advocacy.","volume":"131","author":"Johnson","year":"2013","journal-title":"Pediatrics"},{"issue":"11","key":"2021120907042118500_B20","doi-asserted-by":"crossref","first-page":"1783","DOI":"10.2105\/AJPH.91.11.1783","article-title":"Investigating neighborhood and area effects on health.","volume":"91","author":"Diez Roux","year":"2001","journal-title":"Am J Public Health"},{"key":"2021120907042118500_B21","volume-title":"Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health. Final Report of the Commission on Social Determinants of Health","author":"Commission on Social Determinants of Health","year":"2008"},{"issue":"5","key":"2021120907042118500_B22","doi-asserted-by":"crossref","first-page":"406","DOI":"10.7326\/0003-4819-129-5-199809010-00011","article-title":"Social conditions and self-management are more powerful determinants of health than access to care.","volume":"129","author":"Pincus","year":"1998","journal-title":"Ann Intern Med"},{"issue":"6","key":"2021120907042118500_B23","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1016\/S0277-9536(98)00402-X","article-title":"Gender matters: an integrated model for understanding men\u2019s and women\u2019s health.","volume":"48","author":"Bird","year":"1999","journal-title":"Soc Sci Med"},{"issue":"9","key":"2021120907042118500_B24","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1016\/S0277-9536(00)00416-0","article-title":"Gendered embodiment and survival for young people with cystic fibrosis.","volume":"53","author":"Willis","year":"2001","journal-title":"Soc Sci Med"},{"issue":"4","key":"2021120907042118500_B25","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1016\/j.pcl.2009.05.007","article-title":"Unwarranted variation in pediatric medical care.","volume":"56","author":"Goodman","year":"2009","journal-title":"Pediatr Clin North Am"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/135\/4\/e957\/1060395\/peds_2014-2576.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/135\/4\/e957\/1060395\/peds_2014-2576.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T02:52:48Z","timestamp":1651546368000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/135\/4\/e957\/33515\/Sociodemographic-Attributes-and-Spina-Bifida"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,4,1]]},"references-count":25,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2015,4,1]]},"published-print":{"date-parts":[[2015,4,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2014-2576","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,4,1]]}}}