Cross-sectional study addressing paediatric trauma disparities: a demographic analysis using injury pyramids
Briana Lewis1, Willie Leung2, Rebecca Olsen2
1The RAND School of Public Policy, Santa Monica, California, USA blewis@rand.org.
Summary
Paediatric trauma disparities are evident, with injury pyramids highlighting differences in emergency visits, hospitalizations, and deaths. Targeted prevention strategies are crucial for vulnerable populations, addressing social determinants of health.
Area of Science:
- Public health
- Paediatric trauma research
- Health equity
Background:
- Paediatric injuries are a major global health concern, disproportionately impacting vulnerable groups.
- Social determinants of health, including socioeconomic status, race, and insurance, significantly affect injury outcomes.
- Injury pyramids offer a visual tool to understand and address these disparities.
Purpose of the Study:
- To analyze paediatric trauma incidence and outcomes using injury pyramids.
- To identify disparities in paediatric trauma based on demographic and socioeconomic factors.
- To inform targeted prevention strategies and policy development.
Main Methods:
- Retrospective cohort analysis of 6466 paediatric trauma cases (2010-2021).
- Calculation of incidence rates per 100,000 persons for emergency visits, hospitalizations, and deaths.
- Stratification by sex, age, race, county, and insurance type, with statistical analysis using chi-squared tests.
Main Results:
- Overall incidence rates: 88.6 emergency visits, 47.6 hospitalizations, and 2.4 deaths per 100,000 persons.
- Leading causes: Falls, motor vehicle crashes (MVCs), and sports injuries for visits/hospitalizations; drowning, MVCs, and gunshot wounds for deaths.
- Disparities observed: Higher firearm fatalities in Black children, higher drowning/MVC fatalities in White children. Publicly insured children had greater injury severity.
Conclusions:
- Injury pyramids effectively reveal paediatric trauma disparities, guiding population-specific prevention.
- These pyramids are valuable for intervention development, health equity, and policy.
- Integrating frameworks like the Haddon Matrix and Injury Equity Framework can deepen understanding of social contributors.
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