干旱区生态环境知识资源中心(Arid): Race/Ethnicity and Geographic Access to Urban Trauma Care

Arid

DOI	10.1001/jamanetworkopen.2019.0138
	Race/Ethnicity and Geographic Access to Urban Trauma Care
	Tung, Elizabeth L.; Hampton, David A.; Kolak, Marynia; Rogers, Selwyn O.; Yang, Joyce P.; Peek, Monica E.
通讯作者	Tung, EL (corresponding author), 5841 S Maryland Ave,Mail Code 2007, Chicago, IL 60637 USA.
来源期刊	JAMA NETWORK OPEN
ISSN	2574-3805
出版年	2019
卷号	2 期号:3
英文摘要	IMPORTANCE Little is known about the distribution of life-saving trauma resources by racial/ethnic composition in US cities, and if racial/ethnic minority populations disproportionately live in US urban trauma deserts. OBJECTIVE To examine racial/ethnic differences in geographic access to trauma care in the 3 largest US cities, considering the role of residential segregation and neighborhood poverty. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional, multiple-methods study evaluated census tract data from the 2015 American Community Survey in Chicago, Illinois; Los Angeles (LA), California; and New York City (NYC), New York (N = 3932). These data were paired to geographic coordinates of all adult level I and II trauma centers within an 8.0-km buffer of each city. Between February and September 2018, small-area analyses were conducted to assess trauma desert status as a function of neighborhood racial/ethnic composition, and geospatial analyses were conducted to examine statistically significant trauma desert hot spots. MAIN OUTCOMES AND MEASURES In small-area analyses, a trauma desert was defined as travel distance greater than 8.0 km to the nearest adult level I or level II trauma center. In geospatial analyses, relative trauma deserts were identified using travel distance as a continuous measure. Census tracts were classified into (1) racial/ethnic composition categories, based on patterns of residential segregation, including white majority, black majority, Hispanic/Latino majority, and other or integrated; and (2) poverty categories, including nonpoor and poor. RESULTS Chicago, LA, and NYC contained 798, 1006, and 2128 census tracts, respectively. A large proportion comprised a black majority population in Chicago (35.1%) and NYC (21.4%), compared with LA (2.7%). In primary analyses, black majority census tracts were more likely than white majority census tracts to be located in a trauma desert in Chicago (odds ratio [OR], 8.48; 95% CI, 5.71-12.59) and LA (OR, 5.11; 95% CI, 1.50-17.39). In NYC, racial/ethnic disparities were not significant in unadjusted models, but were significant in models adjusting for poverty and race-poverty interaction effects (adjusted OR, 1.87; 95% CI, 1.27-2.74). In comparison, Hispanic/Latino majority census tracts were less likely to be located in a trauma desert in NYC (OR, 0.03; 95% CI, 0.01-0.11) and LA (OR, 0.30; 95% CI, 0.22-0.40), but slightly more likely in Chicago (OR, 2.38; 95% CI, 1.56-3.64). CONCLUSIONS AND RELEVANCE In this study, black majority census tracts were the only racial/ethnic group that appeared to be associated with disparities in geographic access to trauma centers.
类型	Article
语种	英语
开放获取类型	gold, Green Published
收录类别	SCI-E
WOS记录号	WOS:000465424000094
WOS关键词	DISPARITIES
WOS类目	Medicine, General & Internal
WOS研究方向	General & Internal Medicine
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/369885
作者单位	[Tung, Elizabeth L.] Univ Chicago, Gen Internal Med Sect, Chicago, IL 60637 USA; [Tung, Elizabeth L.] Univ Chicago, Ctr Hlth & Social Sci, Chicago, IL 60637 USA; [Hampton, David A.; Rogers, Selwyn O.] Univ Chicago, Dept Surg, Sect Trauma & Acute Care Surg, 5841 S Maryland Ave, Chicago, IL 60637 USA; [Kolak, Marynia] Univ Chicago, Ctr Spatial Data Sci, Chicago, IL 60637 USA; [Yang, Joyce P.] Stanford Univ, Sch Med, Dept Psychiat & Behav Sci, Stanford, CA 94305 USA; [Yang, Joyce P.] Vet Affairs Palo Alto Hlth Care Syst, Natl Ctr Posttraumat Stress Disorder, Palo Alto, CA USA; [Peek, Monica E.] Univ Chicago, MacLean Ctr Clin Med Eth, Gen Internal Med Sect, Chicago, IL 60637 USA; [Peek, Monica E.] Univ Chicago, Ctr Study Race Polit & Culture, Chicago, IL 60637 USA
推荐引用方式 GB/T 7714	Tung, Elizabeth L.,Hampton, David A.,Kolak, Marynia,et al. Race/Ethnicity and Geographic Access to Urban Trauma Care[J],2019,2(3).
APA	Tung, Elizabeth L.,Hampton, David A.,Kolak, Marynia,Rogers, Selwyn O.,Yang, Joyce P.,&Peek, Monica E..(2019).Race/Ethnicity and Geographic Access to Urban Trauma Care.JAMA NETWORK OPEN,2(3).
MLA	Tung, Elizabeth L.,et al."Race/Ethnicity and Geographic Access to Urban Trauma Care".JAMA NETWORK OPEN 2.3(2019).