The Impact of Social Deprivation on Pediatric Orthopedic Care: A Scoping Review of Disease Burden, Access, and Outcomes.

BACKGROUND

Social deprivation has been linked to disparities in adult orthopedic care, but its impact in pediatric orthopedics remains less well characterized. We conducted a scoping review to evaluate how multidimensional deprivation indices (e.g., Area Deprivation Index, Child Opportunity Index) have been used to assess disparities in pediatric orthopedic care.

METHODS

PubMed, Embase, MEDLINE, and Scopus were searched for English-language studies evaluating social deprivation in pediatric orthopedic populations. Outcomes were categorized into three domains: (1) disease prevalence/risk (2) access to care, and (3) clinical outcomes.

RESULTS

Of 41 included studies most found that greater social deprivation was associated with increased disease prevalence and severity, delayed treatment, reduced follow-up, lower use of nonoperative care, poorer clinical outcomes, higher injury severity, recurrence, and poorer psychosocial PROMs. Disparities were frequently compounded by race, insurance status, and geography.

CONCLUSION

Social deprivation is associated with increased disease prevalence, delayed access, and worse outcomes in pediatric orthopedic care.