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Widening Gaps: Racial and Ethnic Disparities in Adolescent Trauma Trends From 2017 to 2022
Chan Shen1, Ning Li2, Shouhao Zhou3
1Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania; Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.
Summary
Racial disparities in adolescent trauma worsened during COVID-19, with Black and Hispanic youth experiencing higher injury rates and mortality. Firearm-related injuries drove this widening gap, highlighting the need for targeted interventions.
Area of Science:
- Public Health
- Trauma Surgery
- Health Disparities
Background:
- Traumatic injuries are a major cause of death and disability in US adolescents.
- Racial and ethnic minorities are disproportionately affected by trauma.
- The COVID-19 pandemic exacerbated existing socioeconomic and healthcare challenges.
Purpose of the Study:
- To assess trends in adolescent trauma across racial and ethnic groups in the US from 2017-2022.
- To specifically examine the impact of the COVID-19 pandemic on these disparities.
Main Methods:
- Retrospective cohort study using the Trauma Quality Programs Participant Use File (2017-2022).
- Included 282,797 adolescents (12-17 years) with traumatic injuries (fatal and nonfatal).
- Analyzed data stratified by race/ethnicity and trauma periods (pre-COVID vs. COVID), examining injury type, mechanism, intentionality, and severity.
Main Results:
- During the pandemic, the proportion of Black and Hispanic adolescents in trauma cases increased, while non-Hispanic White representation decreased.
- Black adolescents consistently showed higher mortality rates, with the disparity widening significantly during COVID-19 (mortality rate ratio approaching 3).
- Increased firearm-related injuries and assaults among minority adolescents drove the widening gap, persisting through 2022.
Conclusions:
- Persistent and worsening racial disparities in adolescent trauma are evident, particularly for Black and Hispanic youth.
- The findings underscore an urgent need for targeted, culturally responsive interventions.
- Reducing firearm-related injuries is critical to addressing trauma disparities.
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