# Impact of social determinants of health on outcomes in pediatric short bowel syndrome... — GCMD Library

This video discusses a retrospective cohort study from Cincinnati Children's, presented by Lizzy Lee, examining the impact of social determinants of health on outcomes for children with pediatric short bowel syndrome. The study found that factors like distance from the hospital and parental education significantly predict complications such as bloodstream infections and liver disease, as well as the achievement of enteral autonomy. Understanding these social determinants is crucial for better family support in pediatric intestinal rehabilitation programs.

Justyna Maria Wolinska, Christina Belza, Paul William Wales

Objective: To determine the impact of social determinants of health (SDOH) on outcomes in pediatric short bowel syndrome (SBS) patients.

Methods: A retrospective cohort of SBS children managed by an Intestinal Rehabilitation Program was analyzed. Socio-economic variables including income, race, distance to hospital, parental education and immigrant status were chosen to assess whether they independently predicted the following outcomes: enteral autonomy (EA), central line associated blood stream infection (CLABSI), intestinal failure associated liver disease (IFALD), and mortality. Bowel anatomy, prematurity, and disease type were controlled for. Univariate analysis and Cox proportional hazards model (CPH) were performed, where an alpha-value of <0.05 was significant.

Results: A total of 161 patients were analyzed between 2006 and 2019. The median gestational age was 34 (29.0-37.0) weeks and 61.9% were male. EA was achieved in 63.5%, 22.5% developed IFALD, and 10% died. The median CLABSI rate was 4.0 (0.4-11.1) per 1000 catheter days. CPH modeling revealed that the only social factor positively associated with attaining EA was non-white race (p = 0.03). Parental post-secondary education was associated with a lower risk of CLABSI (p = 0.04) while those living larger distances from hospital had an increased risk (p = 0.02). The development of IFALD was also positively associated with greater distance from hospital (p < 0.01). Mortality was positively associated with both having an immigrant background (p = 0.04), non-white race (p = 0.03) and having a parent with post-secondary education (p < 0.01).

Conclusion: Although clinical factors such as anatomy and diagnosis predict prognosis in SBS, social determinants also influence outcomes and should be considered in the support of families.

Type: video · 0 min · posted 2026-08-18
Canonical: https://library.globalcastmd.com/watch/impact-of-social-determinants-of-health-on-outcomes-in-pediatric-short-bowel-syndrome-13896

## Chapters
- [0:00](https://library.globalcastmd.com/watch/impact-of-social-determinants-of-health-on-outcomes-in-pediatric-short-bowel-syndrome-13896?t=0) Social determinants of health in pediatric short bowel syndrome

## Statements
- "This was a retrospective cohort study of children with short bowel syndrome in an intestinal rehabilitation program, followed from 2006 to 2019." — Lizzie Lee (epidemiological) [0:07](https://library.globalcastmd.com/watch/impact-of-social-determinants-of-health-on-outcomes-in-pediatric-short-bowel-syndrome-13896?t=7)
- "The study asked whether social determinants of health predict outcomes like bloodstream infections, liver disease, and achieving enteral autonomy." — Lizzie Lee (epidemiological) [0:16](https://library.globalcastmd.com/watch/impact-of-social-determinants-of-health-on-outcomes-in-pediatric-short-bowel-syndrome-13896?t=16)
- "Social determinants of health do predict outcomes in pediatric short bowel syndrome." — Lizzie Lee (epidemiological) [0:24](https://library.globalcastmd.com/watch/impact-of-social-determinants-of-health-on-outcomes-in-pediatric-short-bowel-syndrome-13896?t=24)
- "Distance from the hospital was associated with higher risks of serious complications in children with short bowel syndrome." — Lizzie Lee (epidemiological) [0:27](https://library.globalcastmd.com/watch/impact-of-social-determinants-of-health-on-outcomes-in-pediatric-short-bowel-syndrome-13896?t=27)
- "Parental education was linked with fewer central line infections in children with short bowel syndrome." — Lizzie Lee (epidemiological) [0:33](https://library.globalcastmd.com/watch/impact-of-social-determinants-of-health-on-outcomes-in-pediatric-short-bowel-syndrome-13896?t=33)
- "Clinicians need to consider social determinants of health to better support families of children with short bowel syndrome." — Lizzie Lee (opinion) [0:37](https://library.globalcastmd.com/watch/impact-of-social-determinants-of-health-on-outcomes-in-pediatric-short-bowel-syndrome-13896?t=37)

## Transcript
Can a child's zip code actually change their short bowel syndrome outcomes? I'm Lizzie Lee from Cincinnati Children's, and this is an article you should know about. This was a retrospective cohort study of children with short bowel syndrome in an intestinal rehabilitation program, followed from 2006 to 2019. They asked this question, Do social determinants of health predict outcomes like bloodstream infections? Liver disease and achieving internal autonomy? And the answer was yes, in very real ways. Distance from the hospital was a big one. Kids who lived farther away had higher risks of serious complications. Parental education showed up too. It was linked with fewer central line infections. So the takeaway is that we do need to consider social determinants so that we can support families better. Let us know what you think below.

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Not medical advice · citation policy: https://library.globalcastmd.com/ai