Society of University SurgeonPedestrians struck by motor vehicles further worsen race- and insurance-based disparities in trauma outcomes: The case for inner-city pedestrian injury prevention programs
Section snippets
Materials and methods
The National Trauma Data Bank (NTDB) is a national trauma registry that is maintained by the American College of Surgeons and contains more than 1.8 million cases reported from more than 900 participating trauma centers in the United States between 2002 and 2006 (version 7.0).
Patients who were treated for pedestrian injuries were identified by International Classification of Diseases, 9th Revision E codes 810.7 through E819.7. Patients aged less than 16 years were excluded because pediatric
Results
A total of 26,404 patients met inclusion and exclusion criteria and were analyzed in the study (Fig). Of these, 51.1% were white, 25.8% were African American, and 16.6% were Hispanic. Baseline age distributions were similar by race, but Hispanic patients had a greater proportion of male patients (77%; 95% confidence interval [CI], 75.8–78.3%) compared with white (67.8%; 95% CI, 67.0–68.5%) and African American (69.5%; 95% CI, 68.4–70.6%) patients (Table I). Compared with white patients, a
Discussion
African American race, Hispanic race, and uninsured status are independent risk factors for mortality among patients hospitalized after pedestrian trauma. This finding demonstrates that greater mortality rates from pedestrian trauma in racial minorities and the uninsured are not simply caused by greater rates of injury. Minority communities suffer a double burden of injury from pedestrian crashes, because African Americans and Hispanics are both more likely to sustain pedestrian trauma6 and
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2019, InjuryCitation Excerpt :Unlike many congenital or acquired diseases, traumatic injuries have high potential for reduced incidence through prevention measures [1,2]. Sociodemographic factors, which include age, race, sex, and socioeconomic status, have a complex effect on health, including injury incidence, treatment patterns, and outcomes [4–20]. Unequal outcomes after trauma also exist, again affected by lack of health insurance, violence, socioeconomic status, and race [9,10,15,21–23].