Effect of parental education and household poverty on recovery after traumatic brain injury in school-aged children

ABSTRACT

Objective

While prior studies have found parental socioeconomic status (SES) affects the outcomes of pediatric traumatic brain injury (TBI), the longitudinal trajectory of this effect is not well understood.

Methods

This prospective cohort study included children 8–18 years of age admitted to six sites with a complicated mild (n = 123) or moderate-severe TBI (n = 47). We used caregiver education and household poverty level as predictors, and multiple quality of life and health behavior domains as outcomes. Differences at 6, 12, and 24 months from baseline ratings of pre-injury functioning were compared by SES. We examined the association between measures of SES and domains of functioning over the 24 months post-injury in children with a complicated mild or moderate- severe TBI, and determined how this association varied over time.

Results

Parental education was associated with recovery among children with complicated mild TBI; outcomes at 6, 12, and 24 months were substantially poorer than at baseline for children with the least educated parents. After moderate-severe TBI, children in households with lower incomes had poorer outcomes compared to baseline across time.

Implications

Parental education and household income were associated with recovery trajectories for children with TBI of varying severity.

KEYWORDS:

• Pediatric brain injury
• recovery
• epidemiology
• socioeconomic

Acknowledgments

The authors wish to thank Marni Levi, Pam Kisala, Elizabeth Wilde, PhD, Karen Walson, MD and the coordinators at each site for their help with the study, and the families and patients for their participation.

Disclaimer

The findings and conclusions in this study are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Disclosure statement

None of the authors report any conflict of interest.

Disclosure

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Additional information

Funding

This study was funded by the Centers for Disease Control and Prevention, grant number U01CE002196.