Neighborhood child opportunity and its association with complicated inguinal hernia in children: an analysis of a national insurance claims-based database.

Theresa Ann Dickerson, Ben Bodek, Laritza Diaz, Chris B Agala, Michael R Phillips, Sean E McLean, Adesola C Akinkuotu

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Article in Pediatric surgery international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

7 authors.

Theresa Ann DickersonUniversity of North Carolina School of Medicine, Chapel Hill, NC, USA.

Ben BodekGillings School of Public Health, University of North Carolina, Chapel Hill, NC, USA.

Laritza DiazDepartment of Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA.

Chris B AgalaDepartment of Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA.

Michael R PhillipsDepartment of Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA.

Sean E McLeanDepartment of Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA.

Adesola C AkinkuotuDepartment of Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA. adesola_akinkuotu@med.unc.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Child Opportunity Index (COI) is a measure of neighborhood conditions associated with healthy child development. Inguinal hernia repair (IHR) is a common pediatric procedure. We sought to evaluate the association between COI and complicated inguinal hernia (IH), incarcerated or strangulated IH, among children with employer-based insurance coverage.

methodsWe performed a retrospective cohort study of children who underwent IHR in the IBM Watson Health MarketScan

resultsA total of 12,084 eligible pediatric patients were identified, of which 3.7%(n = 408) had IH. Children with complicated IH were younger than those with uncomplicated IH (2 vs. 3 years; p = 0.0016). There were no children from very low COI neighborhoods. There was no difference in COI between uncomplicated and complicated IH: (Low- 13.5% vs. 17.2%: Moderate- 67.3% vs. 63.5%; High- 19.2% vs. 19.4%; p = 0.19). Age (aOR: 0.967; 95% CI: 0.95-0.99), but not COI, was independently associated with decreased odds of complicated IH.

conclusionNeighborhood-level disadvantage, as measured by COI 2.0, was not an independent predictor of complicated IH among children with employer-based insurance coverage. LEVEL OF EVIDENCE: II.

Indexed as

Hernia, InguinalHerniorrhaphyNeighborhood CharacteristicsAdolescentChildChild, PreschoolDatabases, FactualFemaleHumansInfantMaleRetrospective StudiesUnited StatesChild opportunity indexDisparitiesInguinal herniaInsuranceOutcomes

Identifiers

PMID40044997

DOI10.1007/s00383-025-05989-w

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