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Original article
Distance to trauma centres among gunshot wound victims: identifying trauma ‘deserts’ and ‘oases’ in Detroit
  1. Giovanni M Circo
  1. Criminal Justice, University of New Haven, West Haven, Connecticut, USA
  1. Correspondence to Dr Giovanni M Circo,Criminal Justice, University of New Haven, West Haven, Connecticut, USA; gcirco{at}newhaven.edu

Abstract

Introduction Among the factors related to survival among individuals with gun shot wounds (GSW) is distance to trauma care. Relatively little is known about neighbourhood-level patterns of GSW mortality and distance to hospitals with trauma centres. This study focuses on distance to the nearest trauma centre as a correlate of survival among GSW victims.

Methods Fatal and non-fatal shooting incident data for 9,205 victimisation in Detroit, Michigan between 2011 and 2017 were collected. A Bayesian conditional autoregressive model was utilised to estimate block-group levels of GSW mortality. Clustering techniques were used to identify spatially proximate neighbourhoods with higher or lower than expected rates of GSW mortality.

Results Distance to the nearest trauma centre was associated with a 22% increase in fatal outcomes, per-mile (OR 1.22, 95% CI, 1.06 to 1.40) after adjusting for block-group level covariates. A Getis-Ord Gi* analysis identified 91 block groups with lower than expected rates of GSW mortality and 12 block-groups with higher than expected rates.

Conclusion Distance to the nearest trauma centre is associated with GSW victim survival. Clusters of block-groups with below-average GSW mortality were observed within close proximity of major trauma centres in Detroit. Improving speed and access to trauma care may play a role in reducing GSW mortality.

  • firearms
  • spatial analysis
  • penetrating injury
  • public health

https://doi.org/10.1136/injuryprev-2019-043180

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    Footnotes

    • Funding This project was supported by Award No. 2013-R2-CX-0015, awarded by the National Institute of Justice, Office of Justice Programs, US Department of Justice.

    • Disclaimer The opinions, findings and conclusions or recommendations expressed in this publication/program/exhibition are those of the author and do not necessarily reflect those of the Department of Justice.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Data may be obtained from a third party and are not publicly available.