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Community-Level Disparities in the Inhalation Injury Patient Population.

Christopher J Fedor1, Mare G Kaulakis1, Hilary Y Liu1

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Journal of Burn Care & Research : Official Publication of the American Burn Association
|March 9, 2026
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Summary
This summary is machine-generated.

Inhalation injuries from fires disproportionately affect socially vulnerable communities. While acute care delivery appears equitable, higher social vulnerability independently predicts increased mortality risk.

Keywords:
Social Vulnerability Indexburnsinhalation injury

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Area of Science:

  • Burn research
  • Public health
  • Emergency medicine

Background:

  • Low-income neighborhoods have higher fire risks and burn severity.
  • Inhalation injuries are common, often requiring intubation and specialized care.
  • Community-level factors like social vulnerability and urbanicity may impact access to care.

Purpose of the Study:

  • To examine how management strategies and clinical outcomes for inhalation injuries vary by social vulnerability and urbanicity.
  • To identify disparities in care and outcomes based on community-level factors.

Main Methods:

  • Retrospective review of 184 patients with inhalation injuries from structure fires (2012-2024).
  • Inhalation injuries diagnosed via bronchoscopy at a single burn center.
  • Community vulnerability assessed using the Social Vulnerability Index (SVI); urbanicity by RUCA codes.

Main Results:

  • Higher social vulnerability associated with more Black individuals and higher asthma prevalence.
  • No significant differences in burn severity, intubation timing, or hospital stay across SVI/urbanicity groups.
  • Rural residents more likely to be transferred from outside hospitals and intubated at the scene.
  • High social vulnerability independently predicted increased mortality risk but not ARDS or pneumonia.

Conclusions:

  • Most inhalation injury patients originate from socially vulnerable communities.
  • Acute care delivery seems equitable across vulnerability levels when resources are available.
  • Higher social vulnerability is linked to increased mortality, highlighting a critical outcome disparity.