Family Income and Recovery Outcomes in Pediatric Burn Survivors: A Burn Model System National Database Study Assessing Functional and Psychosocial Differences

Abstract

Children from lower income families are often disproportionately affected by burns, potentially experiencing greater psychosocial challenges. This study examines whether family income influences the ability of pediatric burn patients to return to baseline function. A retrospective study of pediatric patients (<18 years) from a multi-center longitudinal database between 2015 and 2024 was conducted. There were three cohorts of patients based on income level: <$50 k, $50 k - $100 k, and > $100 k. Return to school and psychosocial outcomes (PROMIS Depression, PROMIS Anger, PROMIS Peer Relationships, PROMIS Anxiety, PROMIS Pain Interference, PROMIS Family Relationships, Post-Traumatic Growth, Body Image, and Pain Intensity) were collected at 12 months after injury by individuals ages 8-17. The final sample consisted of 204 individuals: 115 with income <$50 k, 55 with income $50 k - $100 k, and 34 with income >$100 k. On average, the %TBSA burned was significantly higher (p < .001) and there was a greater incidence of inhalation injury (p = .03) in children with a family income of <50 k. There were no significant differences in any psychosocial outcomes or return to school (p = .40) after adjusting for %TBSA burned. These findings show that lower socioeconomic status does not necessarily impede recovery in pediatric burn survivors, and other factors such as social support may have greater impact on recovery. However, there is a need to address systemic inequalities that contribute to the disproportionate injury burden faced by children from lower income families.