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

Theresa Sukal-Moulton; Michael E Msall; Kristen Wroblewski; Sarah Safdar; Deborah J Gaebler-Spira

doi:10.1111/cch.70028

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

Theresa Sukal-Moulton^*, Michael E Msall, Kristen Wroblewski, Sarah Safdar, Deborah J Gaebler-Spira

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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.

Original language	English (US)
Article number	e70028
Journal	Child: Care, Health and Development
Volume	51
Issue number	1
DOIs	https://doi.org/10.1111/cch.70028
State	Published - Jan 2025

Funding

Funding: Theresa Sukal-Moulton was supported in part by the National Institutes of Health (NIH) R01 NS058667. Michael E. Msall was supported in part by the National Institute of Child Health and Human Development (NICHD) P30 HD054276 Intellectual and Developmental Disabilities Research Center and the Health Resources and Services Administration (HRSA) T73MC11047 Illinois Leadership Education in Neurodevelopmental Disabilities. We acknowledge and thank participants of the CPRR and the recruitment team who assisted with their enrolment (Isabel Aguilar, Donna Hurley and Ashley Lane). Donna Hurley and Sarah Bauer provided helpful input to an earlier version of this manuscript. Theresa Sukal-Moulton was supported in part by NIH R01 NS058667. Michael E. Msall was supported in part by T73 Leadership Education in Neurodevelopmental and Related Disorders Training Program (LEND, T73MC11047) and the Health Resources and Services Administration of the US Department of Health and Human Services (UA6MC32492), the Life Course Intervention Research Network. Preterm Research Node: Engaging Families of Preterm Babies to Optimize Thriving and Well-Being. We acknowledge and thank participants of the CPRR and the recruitment team who assisted with their enrolment (Isabel Aguilar, Donna Hurley and Ashley Lane). Donna Hurley and Sarah Bauer provided helpful input to an earlier version of this manuscript. Theresa Sukal\u2010Moulton was supported in part by NIH R01 NS058667. Michael E. Msall was supported in part by T73 Leadership Education in Neurodevelopmental and Related Disorders Training Program (LEND, T73MC11047) and the Health Resources and Services Administration of the US Department of Health and Human Services (UA6MC32492), the Life Course Intervention Research Network. Preterm Research Node: Engaging Families of Preterm Babies to Optimize Thriving and Well\u2010Being. Theresa Sukal\u2010Moulton was supported in part by the National Institutes of Health (NIH) R01 NS058667. Michael E. Msall was supported in part by the National Institute of Child Health and Human Development (NICHD) P30 HD054276 Intellectual and Developmental Disabilities Research Center and the Health Resources and Services Administration (HRSA) T73MC11047 Illinois Leadership Education in Neurodevelopmental Disabilities. Funding:

Keywords

cerebral palsy
comorbidities
functional outcome
social determinants of health
social disparity

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Developmental and Educational Psychology
Public Health, Environmental and Occupational Health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/cch.70028

Cite this

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title = "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.",

keywords = "cerebral palsy, comorbidities, functional outcome, social determinants of health, social disparity",

author = "Theresa Sukal-Moulton and Michael E Msall and Kristen Wroblewski and Sarah Safdar and Deborah J Gaebler-Spira",

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language = "English (US)",

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AU - Safdar, Sarah

AU - Gaebler-Spira, Deborah J

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N2 - 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.

AB - 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.

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

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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