Impact of Social Disadvantage on Medical and Functional Severity in Children With Cerebral Palsy.

Abstract

Background: Those with neurological disorders like cerebral palsy (CP) may experience an altered impact of social determinates of health on child functioning and well-being. We investigated the relationship between relative social advantage and medical and functional outcomes in a large cohort of children, adolescents and young adults with CP (n = 1269, aged 2-84 years).

Methods: We extracted data from the Cerebral Palsy Research Registry and dichotomized a range of independent factors (income, ethnicity and race) into advantaged and disadvantaged/vulnerable and a range of medical and functional outcomes (gross motor, manual ability, behaviour, breathing, nutritional intake, hearing, seizures, language and vision) and computed odds ratios using logistic regression.

Results: We found significantly more gross and fine motor functional limitations for those with disadvantage in income (p = 0.002 and 0.006), marginalized race (p < 0.001 and 0.062) or ethnicity (p = 0.013 and 0.014). Ethnicity was further implicated in gestational age, whereas minority race played a role in more severe impairments in breathing, nutritional intake, language functioning and low birth weight status.

Conclusion: We found evidence of more health and functional challenges for children with CP and social disadvantage in our cohort. Additional access to equitable resources may improve these imbalances and should be prioritized.