Racial and Educational Isolation Are Associated With Worse Outcomes in Congenital Heart Disease.

Details

• Alternative Title:
  Pediatric Cardiology, 2026, v. 47, no. 1: Racial and Educational Isolation Are Associated With Worse Outcomes in Congenital Heart Disease.
• Journal Article:
  Pediatric Cardiology
• Personal Author:
  Sooy-Mossey, Meredith ; Sethi, Neeta J. ; Mulder, Hillary ; Chiswell, Karen E. ; Hoffman, Timothy M. ; Hartman, Robert J. ; Walsh, Michael J. ; Welke, Karl ; Paolillo, Joseph A. ; Sarno, Lauren A. ; Sang, Charlie J. ; D'Ottavio, Alfred ; Osgood, Claire ; Bravo, Mercedes A. ; Miranda, Marie Lynn ; Li, Jennifer S.
• Description:
  Sociodemographic factors influence outcomes in children with congenital heart disease (CHD). We predict an association between measures of social isolation and outcomes in infants with complex CHD. These measures, racial (RI) and educational (EI) isolation range from 0 to 1, with 0 being no isolation and 1 being fully isolated within a specific population. We identified patients less than 1 year old undergoing CHD surgery in North Carolina from 2008 to 2013. We used negative binomial and logistic regression models to assess the case-mix adjusted associations between RI and EI and length of stay, complications, mortality, and resource utilization. We quantified the association of race with these indices and outcomes. We included 1217 infants undergoing CHD surgery. Black infants had increased LOS (p < 0.001), other complications (p = 0.03), and death (p = 0.02). RI up to 0.3 was associated with decreased outpatient encounters (p < 0.001). RI was associated with increased inpatient encounters RI up to 0.3 (p < 0.001) but decreased for RI beyond 0.3 (p = 0.01). There was an association with increased risk of one or more emergency department visits (p = 0.001) at higher levels of EI. Race and RI showed a cumulative effect with children with Black race and greater than median RI having increased LOS (p < 0.001) and fewer outpatient encounters (p = 0.02). RI, EI, and Black race are associated with poorer outcomes. Children with Black race and greater than median levels of RI are at the highest risk of poor outcomes. These differences may be caused by differential access to resources or community support.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Heart Defects, Congenital
  • Male
  • Female
  • Infant
  • Infant, Newborn
  • Social Isolation
  • Educational Status
  • Retrospective Studies
  • Black or African American
  More +
• Keywords:
  • Complex Congenital Heart Disease
  • Health Disparities
  • Race
  • Racial Isolation
  • Educational Isolation
• Source:
  Pediatric Cardiology, 2026, v. 47, no. 1
• DOI:
  https://doi.org/10.1007/s00246-025-03772-1
• ISSN:
  0172-0643 ; 1432-1971
• Pubmed ID:
  39815062
• Pubmed Central ID:
  PMC12260034
• Document Type:
  Text
• Funding:
  L40 HL170360/HL/NHLBI NIH HHSUnited States/ ; R38 HL143612/HL/NHLBI NIH HHSUnited States/ ; 1NU50DD000054-01-0/CC/CDC HHSUnited States/ ; R38HL143612/HL/NHLBI NIH HHSUnited States/ ; R38HL143612/HL/NHLBI NIH HHSUnited States/ ; 1NU50DD000054-01-0/CC/CDC HHSUnited States/
• Genre:
  Journal Article
• Place as Subject:
  North Carolina
• Pages in Document:
  350-361 (20 pdf pages)
• Volume:
  47
• Issue:
  1
• Download URL:
  https://stacks.cdc.gov/view/cdc/261768/cdc_261768_DS1.pdf
• File Type:
  [PDF - 942.16 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:308adabec943216e2bb9d5ae9123978913847d6a9b338e9cc68511e86c42555afbe94358b3ddecd2da92c88007364a8101902595dbfe86f60be480e09d1641d4