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Pediatric Trauma in the California-Mexico Border Region: Injury Disparities by Area Deprivation Index


The California-Mexico border region is a high-volume trauma area with populations of widely disparate socioeconomic status. This work analyzed differences in demographics and mechanism of injury in children using the Area Deprivation Index (ADI), a composite measure of 17 markers of neighborhood socioeconomic disadvantage. A retrospective review was performed of pediatric patients evaluated at the regional level I Pediatric Trauma Center between 2008 and 2018. Collected data included patient demographics, injury characteristics, and health care outcomes. Patient addresses were correlated to neighborhood disadvantage level using ADI quintiles, with a higher quintile representing greater socioeconomic disadvantage. A total of 9,715 children were identified, of which 4,307 (44%) were Hispanic. Hispanic children were more likely to live in more disadvantaged neighborhoods than non-Hispanic children (p<0.001). There were markedly different injury mechanisms in neighborhoods with greater socioeconomic disadvantage (higher ADI) compared to those with less socioeconomic disadvantage. Sports-related and non-motorized vehicular trauma predominated in less disadvantaged neighborhoods, while higher ADI quintiles were strongly associated with pedestrian versus automobile, motorized vehicle accidents/collisions, and non-accidental trauma (p<0.001). This analysis represents the first study to characterize pediatric traumatic injury patterns based upon the neighborhood ADI metric. ADI can be a useful resource in identifying disparities in pediatric trauma and those at increased risk for vehicular and abusive injury who may benefit from increased resource allocation, social support, and prevention programs

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