Trauma in the Neighborhood: A Geospatial Analysis and Assessment of Social Determinants of Major Injury in North America
Trauma in the Neighborhood: A Geospatial Analysis and Assessment of Social Determinants of Major Injury in North America
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DOI：
10.2105/ajph.2010.300063
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发表时间：
2011-04-01
影响因子：
12.7
通讯作者：
Warden, Craig R.
中科院分区：
文献类型：
--
作者：
Newgard, Craig D.;Schmicker, Robert H.;Warden, Craig R.
目标。我们试图在美国和加拿大的9个不同的城市和县中识别和描述重大创伤事件高发的地区。我们分析了一个前瞻性的、基于人群的受伤个体队列，该队列由163个紧急医疗服务机构评估，这些机构在2005年12月至2007年4月期间将患者运送到研究地点的177家医院。对受伤地点进行地理编码，按人口普查区汇总，评估地理空间聚类，并与社会人口统计措施相匹配。采用负二项模型评价种群测度。急救人员对8786名严重创伤患者进行了评估，其中7326名患者的数据可供分析。我们发现529个（13.7%）人口普查区的重大创伤事件发生率高于预期。在多变量模型中，创伤事件与较高的失业率、较大的非白人居民比例、较小的外国出生居民比例、较低的教育水平、较小的家庭规模、较年轻的年龄和较低的收入水平有关。重大创伤事件倾向于聚集在具有不同人口特征的人口普查区，这表明社会和环境因素可能在重大创伤事件的发生中起作用。[J] .中华卫生杂志，2011;01:669-677。doi: 10.2105 / AJPH.2010.300063)
Objectives. We sought to identify and characterize areas with high rates of major trauma events in 9 diverse cities and counties in the United States and Canada.Methods. We analyzed a prospective, population-based cohort of injured individuals evaluated by 163 emergency medical service agencies transporting patients to 177 hospitals across the study sites between December 2005 and April 2007. Locations of injuries were geocoded, aggregated by census tract, assessed for geospatial clustering, and matched to sociodemographic measures. Negative binomial models were used to evaluate population measures.Results. Emergency personnel evaluated 8786 major trauma patients, and data on 7326 of these patients were available for analysis. We identified 529 (13.7%) census tracts with a higher than expected incidence of major trauma events. In multivariable models, trauma events were associated with higher unemployment rates, larger percentages of non-White residents, smaller percentages of foreign-born residents, lower educational levels, smaller household sizes, younger age, and lower income levels.Conclusions. Major trauma events tend to cluster in census tracts with distinct population characteristics, suggesting that social and contextual factors may play a role in the occurrence of significant injury events. (Am J Public Health. 2011;101:669-677. doi:10.2105/AJPH.2010.300063)