Pedestrians struck by motor vehicles further worsen race- and insurance-based disparities in trauma outcomes: The case for inner-city pedestrian injury prevention programs

Authors

Rubie Sue Maybury, Georgetown University Hospital, Washington, DC, USA
Oluwaseyi B. Bolorunduro, Howard University Hospital, Washington, DC
Cassandra Villegas, The Johns Hopkins University School of Medicine, Baltimore, MD
Elliott R. Haut, The Johns Hopkins University School of Medicine, Baltimore, MD
Kent Stevens, The Johns Hopkins University School of Medicine, Baltimore, MD
Edward E. Cornwell, Howard University College of Medicine, Washington, D.C.
David T. Efron, The Johns Hopkins University School of Medicine, Baltimore, MD
Adil H. Haider, The Johns Hopkins University School of Medicine, Baltimore, MDFollow

Document Type

Article

Department

General Surgery

Abstract

Background: Pedestrian trauma is the most lethal blunt trauma mechanism, and the rate of mortality in African Americans and Hispanics is twice that compared with whites. Whether insurance status and differential survival contribute to this disparity is unknown.
Methods: This study is a review of vehicle-struck pedestrians in the National Trauma Data Bank, v7.0. Patients <16 years and > or =65 years, as well as patients with Injury Severity Score (ISS) <9, were excluded. Patients were categorized as white, African American, or Hispanic, and as privately insured, government insured, or uninsured. With white and privately insured patients as reference, logistic regression was used to evaluate mortality by race and insurance status after adjusting for patient and injury characteristics.
Results: In all, 26,404 patients met inclusion criteria. On logistic regression, African Americans had 22% greater odds of mortality (odds ratio [OR], 1.22; 95% confidence interval [CI], 1.06-1.41) and Hispanics had 33% greater odds of mortality (OR, 1.33; 95% CI, 1.14-1.54) compared with whites. Uninsured patients had 77% greater odds of mortality (OR, 1.77; 95% CI, 1.52-2.06) compared with privately insured patients.
Conclusion: African American and Hispanic race, as well as uninsured status, increase the risk of mortality after pedestrian crashes. Given the greater incidence of pedestrian crashes in minorities, this compounded burden of injury mandates pedestrian trauma prevention efforts in inner cities to decrease health disparities

Comments

This work was published before the author joined Aga Khan University

Publication (Name of Journal)

Surgery

Recommended Citation

Maybury, R. S., Bolorunduro, O. B., Villegas, C., Haut, E. R., Stevens, K., Cornwell, E. E., Efron, D. T., Haider, A. H. (2010). Pedestrians struck by motor vehicles further worsen race- and insurance-based disparities in trauma outcomes: The case for inner-city pedestrian injury prevention programs. Surgery, 148(2), 202-208.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_surg_gen/353