The Impact of Social Deprivation on Pediatric Orthopedic Care: A Scoping Review of Disease Burden, Access, and Outcomes.

BACKGROUND: Social deprivation has been linked to disparities in adult orthopedic care, but its impact in pediatric orthopedics remains less well characterized. We conducted a scoping review to evaluate how multidimensional deprivation indices (e.g., Area Deprivation Index, Child Opportunity Index) have been used to assess disparities in pediatric orthopedic care. METHODS: PubMed, Embase, MEDLINE, and Scopus were searched for English-language studies evaluating social deprivation in pediatric orthopedic populations. Outcomes were categorized into three domains: (1) disease prevalence/risk (2) access to care, and (3) clinical outcomes. RESULTS: Of 41 included studies most found that greater social deprivation was associated with increased disease prevalence and severity, delayed treatment, reduced follow-up, lower use of nonoperative care, poorer clinical outcomes, higher injury severity, recurrence, and poorer psychosocial PROMs. Disparities were frequently compounded by race, insurance status, and geography. CONCLUSION: Social deprivation is associated with increased disease prevalence, delayed access, and worse outcomes in pediatric orthopedic care.