The Social Determinants of Health are everywhere. The University of Chicago recently published a study revealing that African-Americans in big U.S. metropolitan areas are far more likely to live in “trauma deserts” hence having far less access to advanced emergency medical care. Chicago recently invested in an academic medical center level 1 Trauma Center which led to a seven-fold reduction in Chicago’s access disparity. The results of this study were published in the Journal of American Medical Association’s Network Open. The research team examined access to trauma care in Chicago, New York and Los Angeles using a geospatial analysis that compared the location of designated trauma centers with the racial and ethnic composition of the cities’ census tracts. The project included only Level 1 and Level 2 Trauma Centers, which are able to provide medical care to patients with the most serious injuries. In Chicago, the team found that 73 percent of census tracts with a mostly black population were located in trauma deserts. Until UChicago Medicine’s trauma center opened 10 months ago on its Hyde Park medical campus, residents of those communities had 8.5 times higher odds of being farther away from trauma care than people living in the city’s white-majority census tracts. The new trauma center reduced this disparity by nearly 7-fold, to 1.6 times. In New York City, just 14 percent of African-American communities were located in trauma deserts. In Los Angeles, 89 percent of African-American communities were located in trauma deserts, although very few census tracts in Los Angeles remain predominantly African-American. The team said Chicago’s Hispanic and Latino communities were also more likely to be farther from trauma care than those living in white communities. The Hispanic and Latino disparity was not present in New York or Los Angeles.
Elizabeth Tung, MD, MS, a primary care physician and instructor of medicine