Prevalence and ethnic/racial disparities in the distribution of pediatric injuries in South Florida: implications for the development of community prevention programs

Abstract

BackgroundThe state of Florida continues to report significant gender, ethnic and racial disparities in trauma incidence, access to care and outcomes in the adult population. Our objective was to assess pediatric injury profiles and ethnic/racial disparities of specific injuries in a Regional Trauma Center (TC) in South Florida.MethodsRetrospective data from November 2011 to December 2015 were obtained from the Level 2 TC registry for children ≤21 years old. Demographic, injury pattern, geographic area, injury scores and treatment data were analyzed.ResultsOne thousand six hundred ten patients, ages 0–21 years were cared for at the TC from 2011 to 2015.73% were males. Mean age = 15.7 years. Mortality was 2.3%. Using zip code data and using geographic mapping, we identified two main clusters where injuries were occurring. A multinomial regression analysis demonstrated that Hispanics had higher risks of falls (RR 10.4, 95% CI 2.7–29), motorcycle accidents (RR 3.7, 95% CI 1.7–8.2) and motor vehicle accidents (RR 6.4, 95% CI 3.6–11.4). Black/African American children had higher risks of gunshot wounds and resultant mortality (p < 0.01).ConclusionThere were racial, ethnic and gender disparities in the patterns of injury and outcomes among the youth attended at our TC. Geographic mapping allowed us the identification of the zones in South Florida where injuries were occurring. Understanding the differences and using geographic mapping to identify regions of higher prevalence will complement planning for prevention programs.

Relationships between trauma death, disability, and geographic factors: a systematic review

“…We found that 27 of the 32 studies (84.4%) [ 16 , 24 , 25 , 28 – 31 , 34 , 35 , 37 – 54 ] were published after 2010, indicating that geographic factors influencing major trauma have recently become a priority for study. Of the 32 studies, 18 studies [ 16 , 24 , 25 , 27 , 29 , 30 , 32 , 39 – 43 , 45 , 47 – 50 , 52 ] selected study subjects of all ages, eight studies [ 26 , 34 , 35 , 38 , 44 , 46 , 51 , 53 ] were adults, one [ 54 ] studied people in their 50s or older, and five [ 28 , 31 , 33 , 36 , 37 ] studied children and adolescents.…”

Incidence and Geographic Distribution of Injuries Due to Falls Among Pediatric Communities of Maryland

“…A past study reported that whites and African Americans had similar injury-related ED visit rates, although African Americans had more overall visits to the ED 31 . Another study, in a single center, found that Hispanics and whites had a higher relative risk of falls than African Americans 32 . No clear conclusions can be drawn about the effects of race on fall injuries from our statewide data; however, additional analysis is underway to investigate the disparities associated with race/ethnicity and falls geographically.…”

Zip Code–Targeted Injury Prevention Community Outreach Initiatives: Zip Code is as Important as Genetic Code

“…Studies show that about 40 per cent of deaths due to unintentional injuries are actually preventable. 2 Examples of unintentional injuries are events such as motor vehicle accidents, burns, prescription drug overdoses, and falls in the elderly population. Because of the unintentional and preventable nature of many traumatic injuries, trauma centers are required to implement prevention programs that have a vital role in educating the community on preventable injuries.…”

“…Mapping the different types of injuries across population areas serves as an indicator of what type of prevention programs are needed. Irizarry et al (2017) analyzed ethnic/racial disparities in the patterns of injury in a south Florida trauma center. Drawing on the data from their trauma registry, they analyzed demographics, injury patterns, geographic area, injury scores, and outcome data.…”

“…This information can be useful in creating the content for programs and determining the best locations for their implementation. 2 When prevention programs are targeted, they can be an integral part in preventing or reducing the incidence of traumatic injuries evident through the decrease in deaths caused by injuries in some countries. The motor vehicle injury prevention program, created by the San Carlos Apache tribe and implemented alongside the Indian Health Services in Arizona, is an example of a prevention program with a positive impact on the public health of their community.…”