TY - JOUR T1 - Distance to trauma centres among gunshot wound victims: identifying trauma ‘deserts’ and ‘oases’ in Detroit JF - Injury Prevention JO - Inj Prev SP - i39 LP - i43 DO - 10.1136/injuryprev-2019-043180 VL - 25 IS - Suppl 1 AU - Giovanni M Circo Y1 - 2019/09/01 UR - http://injuryprevention.bmj.com/content/25/Suppl_1/i39.abstract N2 - 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. ER -