Sukal-Moulton Theresa, Msall Michael E, Wroblewski Kristen, Safdar Sarah, Gaebler-Spira Deborah J
Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities, Comer Children's Hospital, University of Chicago, Chicago, Illinois, USA.
Child Care Health Dev. 2025 Jan;51(1):e70028. doi: 10.1111/cch.70028.
Those with neurological disorders like cerebral palsy (CP) may experience an altered impact of social determinates of health on child functioning and well-being. We investigated the relationship between relative social advantage and medical and functional outcomes in a large cohort of children, adolescents and young adults with CP (n = 1269, aged 2-84 years).
We extracted data from the Cerebral Palsy Research Registry and dichotomized a range of independent factors (income, ethnicity and race) into advantaged and disadvantaged/vulnerable and a range of medical and functional outcomes (gross motor, manual ability, behaviour, breathing, nutritional intake, hearing, seizures, language and vision) and computed odds ratios using logistic regression.
We found significantly more gross and fine motor functional limitations for those with disadvantage in income (p = 0.002 and 0.006), marginalized race (p < 0.001 and 0.062) or ethnicity (p = 0.013 and 0.014). Ethnicity was further implicated in gestational age, whereas minority race played a role in more severe impairments in breathing, nutritional intake, language functioning and low birth weight status.
We found evidence of more health and functional challenges for children with CP and social disadvantage in our cohort. Additional access to equitable resources may improve these imbalances and should be prioritized.
患有脑瘫（CP）等神经系统疾病的患者，其健康的社会决定因素对儿童功能和福祉的影响可能会发生改变。我们调查了一大群患有CP的儿童、青少年和年轻人（n = 1269，年龄2至84岁）的相对社会优势与医疗和功能结局之间的关系。
我们从脑瘫研究登记处提取数据，将一系列独立因素（收入、种族和民族）分为优势和劣势/弱势群体，并将一系列医疗和功能结局（粗大运动、手动能力、行为、呼吸、营养摄入、听力、癫痫发作、语言和视力）进行二分法处理，然后使用逻辑回归计算比值比。
我们发现，收入处于劣势（p = 0.002和0.006）、种族边缘化（p < 0.001和0.062）或民族处于劣势（p = 0.013和0.014）的人群，其粗大和精细运动功能受限的情况明显更多。民族因素与胎龄进一步相关，而少数族裔在呼吸、营养摄入、语言功能和低出生体重状况的更严重损害中起作用。
我们在队列研究中发现，患有CP且处于社会劣势的儿童面临更多健康和功能挑战的证据。增加公平资源的获取可能会改善这些不平衡状况，应将其作为优先事项。
