Association Between Childhood Opportunity Index and Pediatric Emergency Department Utilization of Youth With Experiences of Trafficking: A National Multicenter Retrospective Cohort Study.

OBJECTIVE: To understand associations between the Child Opportunity Index (COI), a neighborhood-based measure of resources that influence child health and development, and pediatric ED utilization among youth with experiences of trafficking in the United States, as well as to describe their range of COI, sociodemographic characteristics, and pediatric ED utilization. METHODS: This was a retrospective, observational, cohort study. We identified (by ICD-10 code) youth with experiences of trafficking who presented to pediatric EDs across 50 US children's hospitals between January 2018 and February 2023 within the Pediatric Health Information System database. Descriptive analyses and multivariate regression were performed. RESULTS: We identified 908 youth with experiences of trafficking who presented to pediatric EDs. Among them, 55% (n=499) were from neighborhoods with Very Low and Low COI, while 45% (n=409) were from neighborhoods with Moderate to Very High COI. Mental health diagnoses were common (n=584, 65.3%), and mental health, child abuse, and physical trauma were the top diagnosis categories for ED visits. Low-resource intensity visits were uncommon (12.8%). One-third of patients had an ED visit in the year prior. We did not find major statistically significant associations between COI and hospital utilization. CONCLUSIONS: In this cohort of youth with experiences of trafficking, all levels of COI and a wide range of visit acuity levels were represented. Further study is needed to better understand the prevalence and health needs of youth with experiences of trafficking who receive ED care, to develop effective screening and intervention programs to support these youth.