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10 March, 2019 00:00 00 AM
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Living in trauma care ‘deserts’

Living in trauma 
care ‘deserts’

Black neighbourhoods in America's three largest cities are much more likely to be located in a "trauma desert," an area without immediate access to a designated trauma center, a new study finds. Census data for neighborhoods in New York City, Chicago and Los Angeles revealed that neighbourhoods made up of mostly black residents are more often 5 miles or more away from a trauma center, compared with white or Hispanic neighbourhoods, researchers said.

"We found that black neighbourhoods were the only neighbourhoods that were consistently in trauma deserts," said lead researcher Dr. Elizabeth Tung, an internal medicine and primary care instructor with University of Chicago Medicine.

This means that medical care for stabbings, shootings and beatings is lacking in the urban areas most affected by violent crime, the researchers said.

Tung's team noted that the rate of violent crime in rural Thurmont, Md., is five victims for every 10,000 people. The rate just 60 miles away, in urban Baltimore, is more than 25 times higher.

"When you think about who needs access to these services, it's really the poor inner-city neighbourhoods, and those are the neighbourhoods least likely to have access," Tung said.

Previous studies have associated urban trauma care deserts -- or regions located more than 5 miles from a trauma center -- with higher transport times and an increased risk of death, according to background notes in the study published online March 8 in JAMA Network Open.

For the new study, the investigators analysed data from the 2015 American Community Survey, an annual research effort by the US Census Bureau.

The researchers used the survey to assess the racial makeup of specific neighborhoods in the three largest US cities. They found large proportions of majority-black neighbourhoods in Chicago (35 per cent) and New York City (21 per cent), but not in Los Angeles (3 per cent).

The investigators then compared the location of those neighbourhoods to the sites of adult level I and level II trauma centres within the three cities.

The findings showed that black-majority neighbourhoods were eight times more likely to be located in a trauma care desert in Chicago and five times more likely in Los Angeles. They also were nearly twice as likely in New York City to be in a trauma care desert, in models adjusting for poverty and race.

Interestingly, Hispanic-majority neighbourhoods did not consistently have the same problem. They were actually less likely to be located in a trauma care desert in New York City and Los Angeles, and slightly more likely in Chicago, according to the report.

Many "safety net" trauma hospitals in poorer urban areas have shut down or scaled back operations over the years, as welfare and Medicaid funding have tightened, Tung said.

This makes emergency care less available to people in those neighbourhoods.

Examples include Michael Reese Hospital on the south side of Chicago, which closed in 1991 due to economic hardship, and Martin Luther King Jr. Hospital in Los Angeles, which lost its trauma center designation in 2004, the researchers noted.

On the other hand, activists in New York City rallied around Harlem Hospital and headed off its closure twice, which could explain why the Big Apple's black communities are not as likely to be in a trauma care desert, Tung said.

  HealthDay    

                                                                            

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Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

Editor : M. Shamsur Rahman
Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

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