Associations of neighborhood social vulnerability with emergency department visits and readmissions among infants with bronchopulmonary dysplasia

Objectives To characterize associations of the CDC Social Vulnerability Index (SVI) with medically attended acute respiratory illness among infants with bronchopulmonary dysplasia (BPD). Study design Retrospective cohort of 378 preterm infants with BPD from a single center. Multivariable logistic regression quantified associations of SVI with medically attended acute respiratory illness, defined as emergency department (ED) visits or hospital readmissions within a year after first hospital discharge. Mediation analysis quantified the extent to which differences in SVI may explain known Black-White disparities in medically attended acute respiratory illness. Results SVI was associated with medically attended respiratory illness (per SVI standard deviation increment, aOR 1.44, 95% CI: 1.17–1.78). Adjustment for race and ethnicity attenuated the association (aOR 1.27, 95% CI: 0.97–1.64). SVI significantly mediated 31% of the Black-White disparity in ED visits (p = 0.04). Conclusions SVI was associated with, and may partially explain racial disparities in, medically attended acute respiratory illness among infants with BPD.