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March 2003, Vol 93, No. 3 | American Journal of Public Health 461-466
© 2003 American Public Health Association


RESEARCH AND PRACTICE

A Population-Based Analysis of Socioeconomic Status and Insurance Status and Their Relationship With Pediatric Trauma Hospitalization and Mortality Rates

James P. Marcin, MD, MPH, Michael S. Schembri, MS, Jingsong He, MS and Patrick S. Romano, MD, MPH

James P. Marcin is with the Department of Pediatrics and the Center for Health Services Research in Primary Care, University of California, Davis. Jingsong He and Michael S. Schembri are with the Center for Health Services Research in Primary Care. Patrick S. Romano is with the Division of General Internal Medicine, the Department of Pediatrics, and the Center for Health Services Research in Primary Care.

Correspondence: Requests for reprints should be sent to James P. Marcin, MD, MPH, Department of Pediatrics, Section of Critical Care Medicine, 2516 Stockton Blvd, Sacramento, CA 95817 (e-mail: jpmarcin{at}ucdavis.edu).

Objectives. We investigated socioeconomic disparities in injury hospitalization rates and severity-adjusted mortality for pediatric trauma.

Methods. We used 10 years of pediatric trauma data from Sacramento County, Calif, to compare trauma hospitalization rates, trauma mechanism and severity, and standardized hospital mortality across socioeconomic strata (median household income, proportion of households in poverty, insurance).

Results. Children from lower–socioeconomic status (SES) communities had higher injury hospitalization and mortality rates, and presented more frequently with more lethal mechanisms of injury (pedestrian, firearm), but did not have higher severity-adjusted mortality.

Conclusions. Higher injury mortality rates among children of lower SES in Sacramento County are explained by a higher incidence of trauma and more fatal mechanisms of injury, not by greater injury severity or poorer inpatient care.




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