RESUMEN
OBJECTIVE: To examine the influence of economic connectedness (EC), a measure of social capital, on obstructive sleep apnea (OSA) severity and adenotonsillectomy outcomes in children. STUDY DESIGN: Retrospective study. SETTING: Single tertiary medical center. METHODS: The study population included 286 children who were referred for full-night polysomnography for OSA and underwent adenotonsillectomy. The primary outcome was the relationship between EC and the presence of severe OSA, and secondary outcomes included postoperative emergency room visits and residual OSA after adenotonsillectomy. Linear regression, Kruskal-Wallis test, Pearson's χ2 test, and multiple logistic regression were used for categorical and continuous data as appropriate. RESULTS: In this population, the median age was 9.0 (interquartile range [IQR] = 6.9-11.7) and 144 (50.3%) were male. The majority were white (176, 62.0%), black (60, 21.1%), and/or of Hispanic ethnicity (173, 60.9%). The median EC of this population was 0.64 (IQR = 0.53-0.86). Higher EC was associated with decreased odds of having severe OSA (odds ratio: 0.17, 95% confidence interval = 0.05-0.61). However, EC was not associated with either postoperative emergency room visits or residual OSA. CONCLUSION: EC was significantly associated with severe OSA (ie, apnea-hypopnea index ≥ 10) but not with postoperative emergency room visits or residual OSA after adenotonsillectomy. Further research is needed to understand the effects of various social capital measures on pediatric OSA and adenotonsillectomy outcomes.
RESUMEN
Social capital is an important social determinant of health, more specifically bridging social capital, which connects individuals and communities across societal divides. This article reports on the findings of a study about the relationship between bridging social capital and COVID-19 infection trends within the state of Arizona from October 2020 to November 2021. Economic connectedness (EC), derived from Facebook friendship connections, served as a measure of aggregated bridging social capital among residents in each ZCTA (ZIP code tabulation area). Analysis of 192 ZCTAs in Arizona revealed that below-median SES individuals had fewer above-median SES friends (mean EC = 0.86). Multiple linear regression analyses were conducted to assess the correlation between EC and biweekly COVID-19 case growth, adjusting for other social determinants of health. Results showed that higher EC was associated with slower biweekly COVID-19 case growth (p < 0.001). This suggests that bridging social capital plausibly facilitated members of underserved and vulnerable groups to better access health-related information during the COVID-19 pandemic, thereby reducing the risks of infection during the pandemic. These findings suggest that promoting bridging social capital, particularly through social network sites, could be leveraged during early phase of public health crisis. The article concludes by recommending to strengthening bridging social capital for individuals with limited access to public health information and medical care.