Citation

Newgard CD, Schmicker RH, Sopko G, Andrusiek D, Bialkowski W, Minei JP, Brasel KJ, Bulger E, Fleischman RJ, Kerby JD, Bigham BL, Warden CR. Am. J. Public Health 2011; 101(4): 669-677.

Affiliation

Correspondence should be sent to Craig D. Newgard, Department of Emergency Medicine, Center for Policy and Research in Emergency Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Mailcode CR-114, Portland, OR 97239-3098. newgardc@ohsu.edu Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.

Copyright

(Copyright © 2011, American Public Health Association)

DOI

10.2105/AJPH.2010.300063

PMID

21389292

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.

Language: en