Faculty Collaboration Database

Trauma in the neighborhood: a geospatial analysis and assessment of social determinants of major injury in North America. Am J Public Health 2011 Apr;101(4):669-77

Date

03/11/2011

Pubmed ID

21389292

Pubmed Central ID

PMC3052353

DOI

10.2105/AJPH.2010.300063

Scopus ID

2-s2.0-79955673433 (requires institutional sign-in at Scopus site)   30 Citations

Abstract

OBJECTIVES: We sought to identify and characterize areas with high rates of major trauma events in 9 diverse cities and counties in the United States and Canada.

METHODS: We analyzed a prospective, population-based cohort of injured individuals evaluated by 163 emergency medical service agencies transporting patients to 177 hospitals across the study sites between December 2005 and April 2007. Locations of injuries were geocoded, aggregated by census tract, assessed for geospatial clustering, and matched to sociodemographic measures. Negative binomial models were used to evaluate population measures.

RESULTS: Emergency personnel evaluated 8786 major trauma patients, and data on 7326 of these patients were available for analysis. We identified 529 (13.7%) census tracts with a higher than expected incidence of major trauma events. In multivariable models, trauma events were associated with higher unemployment rates, larger percentages of non-White residents, smaller percentages of foreign-born residents, lower educational levels, smaller household sizes, younger age, and lower income levels.

CONCLUSIONS: Major trauma events tend to cluster in census tracts with distinct population characteristics, suggesting that social and contextual factors may play a role in the occurrence of significant injury events.

Author List

Newgard CD, Schmicker RH, Sopko G, Andrusiek D, Bialkowski W, Minei JP, Brasel K, Bulger E, Fleischman RJ, Kerby JD, Bigham BL, Warden CR, Resuscitation Outcomes Consortium Investigators

Author

Walter Biakowski in the CTSI department at Medical College of Wisconsin - CTSI

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Cohort Studies
Emergency Medical Services
Female
Humans
Male
Middle Aged
North America
Prospective Studies
Residence Characteristics
Wounds and Injuries
Young Adult