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BACKGROUND: Research has consistently shown that community-level socioeconomic (SES) indicators are associated with injury, including motor vehicle crash. Health literacy, perhaps the newest SES indicator, is the capacity to understand basic health information and make appropriate health decisions (Koh et al., Health Affairs, 2012). Health literate populations may be better equipped for good health outcomes due to their understanding of current health and prevention messages. The purpose of the analysis is to observe whether community characteristics are associated with inequalities in crash characteristics and outcomes.
METHODS: Using commercial marketing demographic data (Nielsen Claritas) from the community level (including county, ZIP code, and Census tract), characteristics of the geographical area in which crash victims reside were obtained. Injury outcome and crash characteristics from linked crash and hospital data from the Crash Outcome Data Evaluation System (CODES) were compared to community-level measures such as community demographics, socioeconomic factors and a health literacy score developed by the Center for Health Promotion at the Minnesota Department of Health. ArcGIS was used for map overlays.
RESULTS: Analyses indicated an association (p=0.05) between health literacy scores and rates of hospital-treated crashes at the county level. The r-square was relatively low (0.04 ) indicating additional multivariate analyses could better explain the variance of the outcome. Further analyses were performed with various community-level indicators, indicating similar associations with other types of injury, such as falls.
CONCLUSIONS: Community-specific inequalities in crash characteristics and outcomes point to the need for more health literate or readily understandable signage as part of our transportation systems' prevention efforts. Further, an emphasis on health literacy and other social determinants of health can be used in providing better, patient-centered hospital intervention and treatment to crash or injury victims. Commercial marketing demograhic data can be used to guide these prevention and intervention efforts.