Online Program

Statewide Analysis of Racial Disparities and Assault in Pediatric Trauma Patients

Monday, November 2, 2015

Allison Ertl, MS, Department of Public and Community Health, Medical College of Wisconsin, MIlwaukee, WI
Laura Cassidy, PhD, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI
Background/Purpose: Black children experience an inequitable burden of violence. This study analyzed data from the Ohio trauma registry that includes 90% of Ohio hospitals including a large number of non-trauma centers.  Therefore, this is the first statewide analysis of racial disparities in assault for pediatric patients.

Methods:Assault was identified in 653 patients under 16 years old. Data were compared by race for 653 patients < 16 years old using a chi-square test. Logistic regression evaluated associations between race and mortality adjusting for injury severity score (ISS).

Results/Outcomes: 51% of white children were < 1yr old compared to 26% of black children (p<0.001).  14-15 year old black children suffered the highest proportion of assaults (36% vs 9%). Black children were more likely undergo an operative procedure  (29% vs 14%, p<0.001), experience a complication (14% vs 2%, p<0.001) a penetrative injury (42% vs 8%, p<0.0001), or firearm-related injury(14% vs 7%, p<0.0001).  87% went directly to at trauma center vs 75% of white children (p<0.001). Black children were more likely to die after adjusting for ISS (OR=2.1, 95%CI 1.2-3.6) Days between injury and arrival were significantly longer for black children.

Conclusions:  Assault is most prevalent in white children less than one year old, suggesting abuse compared to adolescent black children who have a high proportion of firearm injuries and sustain more severe injuries.  Black children tend to have closer proximity to trauma centers yet have a delay in care and twice the mortality rate even after adjusting for severity.

Learning Areas:

Biostatistics, economics
Planning of health education strategies, interventions, and programs
Public health or related public policy
Public health or related research

Learning Objectives:
Describe statewide racial differences in assault among pediatric trauma patients.

Keyword(s): Violence & Injury Prevention, Health Disparities/Inequities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have completed multiple graduate courses in biostatistics covering the methods used to conduct the analysis. Furthermore, I have participated in numerous trauma-related projects as a student researcher and have been included on related publications.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.