As a volunteer EMT and trainee paramedic, this SRxA Word on Health blogger has seen, all too frequently, the tragic consequences of pedestrian trauma.
These are never good calls. Regardless of the cause or the circumstances, in the battle of man-versus-metal, it’s rarely the car that suffers. In such circumstances, we do everything we can, and like to think that our interventions play a critical role in the survival of such patients.
However, new research from Johns Hopkins suggests that the victims’ race and economic factors are also crucial determinants of outcome. According to a study just published in Surgery, even if the injuries sustained are similar, uninsured, minority pedestrians hit by cars are at a significantly higher risk of death than their insured white counterparts.
The death rate disparity is compounded by the fact that minority pedestrians are far more likely than white pedestrians to be struck by motor vehicles.
“It’s a double whammy,” says Adil H. Haider, M.D., M.P.H., an assistant professor of surgery at the Johns Hopkins University School of Medicine and the study’s senior author. “Minorities are much more likely to get injured by this mechanism and much more likely to die by this mechanism.”
Researchers reviewed National Trauma Data Bank information on 26,404 patients hit by vehicles between 2002 and 2006. African-American patients had a 22% greater risk of death and Hispanic patients a 33% greater risk of death than white patients involved in similar crashes. Meanwhile, the researchers said, uninsured patients had a 77% greater risk of death than those who were insured.
“Do we treat minorities and the uninsured differently? I don’t think so, but we’ve got to ask the question,” added Haider.
A greater prevalence of, or lack of treatment for, co-morbidities, such as obesity, diabetes or hypertension, could be factors that raise the risk of death among injured minority or uninsured crash victims.
Since the underlying causes of the disparities can’t be easily answered, Haider says, policy makers need to focus in the short term on better pedestrian injury-prevention programs, particularly in the inner city, where many of these deadly crashes occur.
Here at Word on Health, we say “Be Careful.” Much as we love our readers, let’s not meet on an ambulance.