Impact of Child Opportunity Index on Severity of Pediatric Drowning Outcomes

A cross-sectional study using data from the Pediatric Health Information System (2016–2021) demonstrates a significant association between community-level socioeconomic disadvantage and the severity of drowning outcomes in children.

The analysis included 4,247 children aged 0–18 years with unintentional drowning events. Most patients were between 1–4 years of age (63%), and 58% were male. Severe drowning was defined as the need for invasive or noninvasive respiratory support, ICU admission, cardiac arrest, poor neurologic outcome, and/or death.

Using the Child Opportunity Index (COI) as the primary exposure variable, investigators performed multivariable logistic regression to assess the relationship between COI and severe drowning. Compared with children from very high-opportunity communities, those from very low (OR 1.51; 95% CI 1.07–2.15), low (OR 1.61; 95% CI 1.19–2.17), and moderate (OR 1.29; 95% CI 1.02–1.63) COI areas had significantly higher odds of severe drowning outcomes.

Similarly, the odds of poor neurologic outcomes were markedly elevated in children from very low (OR 2.33; 95% CI 1.43–3.81), low (OR 2.26; 95% CI 1.45–3.52), and moderate (OR 1.69; 95% CI 1.05–2.72) COI communities.

  Children residing in lower-opportunity environments experience substantially worse clinical outcomes following drowning. Enhanced, community-specific drowning-prevention initiatives may help mitigate these disparities and reduce the incidence of severe outcomes.

 Source: The Association Between Child Opportunity Index and Severe Drowning in Children

Mottla, Mary E. et al. The Journal of Pediatrics, Volume 285, 114674