Racial and Ethnic Disparities in Trauma Rates Regardless of Urbanicity in Arizona **

BACKGROUND:  The association between race/ethnicity and trauma is well documented; however most studies have focused on specific races, age groups, injury types, or region of the U.S. The purpose of this study is to compare the trauma rates among different racial/ethnic groups in Arizona after adjusting for age and urban/rural location of injury (urbanicity).

METHODS:  The Arizona State Trauma Registry included data from 8 Level I and 15 Level IV trauma centers, and 4 non-designated hospitals between 2011 and 2012.  Population denominators were obtained from the Arizona Vital Statistics (Arizona Department of Health Services). Location and age-adjusted overall trauma rates per 100,000 Arizona residents were calculated to compare the relative risks (RR) and 95% confidence interval (95% CI) using Statistical Analysis Software (SAS) version 9.3.  We further evaluated the risk of trauma by mechanism of injury, alcohol use and fatality.

RESULTS:  Out of 58,034 trauma cases, 57% were White non-Hispanic (WNH), 11% American Indian/Alaska Native (AI/AN), 1% Asian/Pacific Islander (Asian), 4% Black/African American (Black), and 27% Hispanic. After controlling for age and location, AI/AN had significantly higher risk of trauma (RR-1.7, 95% CI 1.6-1.7), especially alcohol-related trauma (RR-5.6, 95% CI 5.4.0-5.7), struck by/against (RR-4.0, 95% CI 3.8-4.1), and cut/pierce (RR-5.3, 95% CI 5.1-5.6) as compared to WNH.  Asian had significantly lower risk of trauma in all categories. Black had significantly higher risk of penetrating trauma, specifically firearm injuries (RR-3.8, 95% CI 3.6-4.5) and cut/pierce (RR-2.6, 95% CI 3.6-4.0). The risk of trauma for Hispanic was similar to WNH with the exception of a higher risk of penetrating injury. 

CONCLUSIONS:  Our findings show that racial/ethnic trauma disparities in Arizona are independent factors from age and urbanicity. Further studies should focus on contributing factors influencing the risk of trauma for each racial/ethnic group, which may aid in targeted injury prevention efforts.