754 Social Determinants Associated with Paediatric Burn Injury: A Population Based, Case-control Study

Abstract

Abstract Introduction Children are disproportionately represented as victims of burn injury compared to adults. Life-long sequelae post-burn manifest as increased rates of mental and physical illness, substance abuse, and suicide. Social determinants of health (SDoH) influence risk of injury, however the extent and influence of SDoH on burn injury is less clear. To determine which social determinants influence burn injury in children, a retrospective case-control study was conducted. Methods Children (< 17 years of age) admitted to a regional burn centre between January 1 1999 and March 30 2017 were matched based on age, sex and geographic location 1:5 with an uninjured cohort. Population level administrative data describing the SDoH, at the regional administrative multifaceted data repository were compared between the cohorts. Thirteen SDoH were chosen based on a systematic review conducted by the research team. Results No significant differences existed in descriptive statistics between the burn and control cohorts. Mean age at burn injury = 5.46 (± 5.23), average TBSA (%) = 10.5 (± 13.4). The most common mechanism of burn injury was scald (42.03%) Upon multivariable logistic regression, children: from a low-income household (O.R. 1.97 (1.46, 2.65)); in foster care (O.R. 1.57 (1.11, 2.21)); from a family that received income assistance (O.R. 1.71 (1.33, 2.19)); or born to a teen mother (O.R. 1.43 (1.13, 1.81)) were associated with an increased risk of burn injury. Conclusions This study identified SDoH associated with an increased risk of burn injury. This case-control study supports the finding that children from a low-income household, children in care, from a family that received income assistance, and children born to a teen mother are at an elevated risk of burn injury. Applicability of Research to Practice Identifying children at increased potential risk provides an opportunity to prevent burn injuries, bypassing the associated long-term physical disfigurement, life-long mental health consequences and mortality. This study also has merit in maximizing the efficiency of a burn prevention budget through targeted burn safety and risk reduction programs.