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Firearm Mortality and Equitable Access to Trauma Care in Chicago
Michael R Poulson1, Andrew Benjamin2, Dane R Scantling3
1Section for Trauma and Acute Care Surgery, Department of Surgery, University of Chicago Medicine & Biological Sciences, Chicago, Illinois.
Importance:
Trauma deserts are areas with limited access to trauma care, particularly affecting marginalized and racial and ethnic minority communities in urban areas that are already disproportionately affected by firearm injuries. Distance and time to trauma care after firearm injury have been shown to be significantly associated with mortality.
Objective:
To evaluate the association of opening a level 1 trauma center in an urban trauma desert with mortality from firearm injuries.
Design, Setting, And Participants:
This cohort study used an interrupted time-series analysis of 45 150 shooting incidents in Chicago between 2010 and 2024, comparing mortality before and after the May 2018 opening of the University of Chicago trauma center.
Exposures:
Shooting incidents within and outside the University of Chicago service area (UCSA).
Main Outcomes And Measures:
Primary outcomes included changes in distance and travel time to nearest trauma center and changes in mortality from firearm injuries. Analysis compared the area around the University of Chicago (UCSA) with the area not serviced by the UCSA (non-UCSA).
Results:
This cohort study examined 45 150 shooting incidents in Chicago between 2010 and 2024. With the opening of the trauma center in May 2018, there was a reduced mean travel time in the UCSA of 9.5 minutes (95% CI, 8.8-10.1 minutes; P < .001) and a reduced mean travel distance of 3.4 miles (95% CI, 3.18-3.65 miles [to convert to kilometers, multiply by 1.6]) (P < .001). At the interrupted time point, there was a 3.9% (95% CI, 6.8%-1.1%) proportionate decrease in mortality from firearm injuries in the UCSA (P = .007) with no significant change in mortality in the non-UCSA.
Conclusions And Relevance:
Strategic placement of this trauma center in an area with high rates of violent injury and limited trauma care access was associated with significantly reduced mortality within the service area. These findings should inform trauma system planning to address geographic disparities in trauma care access, particularly in communities with high rates of penetrating trauma.
