Poster #104 - Race and SES in Relation to Parent Measures of Stress After Pediatric Burn Injury

• In Event: 3-053 - Poster Session 10
  In Poster Session: PS 10 Section - Health, Growth, Injury

Integrative Statement

The impact of burn injuries are disproportionately more significant in minority populations such as racial minorities and children from low socioeconomic status (e.g. Fagenhoz et al., 2007). Epidemiological research also suggests that minorities are more vulnerable to greater psychological distress with increased risks of experiencing traumatic events and also developing post-traumatic stress disorder (PTSD) after those events (e.g. Robert et al., 2007). The disproportionate frequency of burn injuries and elevated vulnerability to PTSD after a traumatic event indicate the need for attention towards social contextual factors such as race and socioeconomic status (SES) when studying the impact of pediatric burn injuries.

Emerging researches suggest that clinically significant post-burn symptoms corresponding to depression, guilt, and post-traumatic stress are common in parents of pediatric burn patients (e.g. Bakker et al., 2012). These finding are increasingly relevant as further data indicates the foremost role of parental stress in predicting child’s quality of life after a burn beyond factors such as severity of burn (Perry-Parrish et al., 2016). There is a need for more extensive examination of parental response to pediatric burn injuries to improve the supporting of at-risk populations.

This study addresses such need by looking variables of child race (white or black) and SES through insurance type (private or medical assistance) in relation to parent measures of post-burn stress. Participants were parents of pediatric burn patients (N = 602; 48.3% white; 39.0% private insurance) screened in a large multidisciplinary clinic by a pediatric psychologist using the Short Post-Traumatic Stress Disorder Rating (SPRINT; Connor & Davidson, 2001). There was a much higher proportion of medicaid/medicare insured parents of black children than in parents of white children (white: 38.5%, black: 82.0%).

Linear regression analysis with independent variables of age, sex, insurance type, degree of burn and total body surface area of burn (TBSA) showed that insurance type (Beta = .109, p < .05) significantly predicted parent distress. However, insurance type was no longer significant once race was added to the model (F (6, 220) = 6.507; p < .001; adjusted rsq = .069) and race emerged as the most significant predictor of parent distress (Beta = .175; p = .001). Following race as predictors were TBSA (Beta = .152; p = .001) and sex (Beta = .116; p = .012). An independent samples t-test indicated that parents of black children endorsed higher levels of distress than parents of white children following burn injuries (black = 7.40; white = 4.86; p < .001).

Our proxy variable of SES, insurance type, did not have a significant effect on parental distress when separated from the impact of race. This result raises the issue of other factors that contribute to the elevated psychological distress of parents of black youth experiencing burn injuries, beyond socioeconomic disadvantage, such as concern regarding changes in physical appearance.

Authors

• Youlim Song, Johns Hopkins University
  Presenting Author

• Dylan Stewart, Johns Hopkins School of Medicine
  Non-Presenting Author

• Susan Ziegfeld, Johns Hopkins School of Medicine
  Non-Presenting Author

• Rick Ostrander, Johns Hopkins School of Medicine
  Non-Presenting Author

• Carisa Parrish, Johns Hopkins School of Medicine
  Non-Presenting Author