Racial, Gender, and Neighborhood-Level Disparities in Pediatric Trauma Care
Background Disparities in trauma outcomes and care are well established for adults, but the extent to which similar disparities are observed in pediatric trauma patients requires further investigation. The objective of this study was to evaluate the unique contributions of social determinants (race,...
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| Veröffentlicht in: | Journal of racial and ethnic health disparities 2023-06, Vol.10 (3), p.1006-1017 |
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| creator | Dickens, Harrison Rao, Uma Sarver, Dustin Bruehl, Stephen Kinney, Kerry Karlson, Cynthia Grenn, Emily Kutcher, Matthew Iwuchukwu, Chinenye Kyle, Amber Goodin, Burel Myers, Hector Nag, Subodh Hillegass, William B. Morris, Matthew C. |
| description | Background
Disparities in trauma outcomes and care are well established for adults, but the extent to which similar disparities are observed in pediatric trauma patients requires further investigation. The objective of this study was to evaluate the unique contributions of social determinants (race, gender, insurance status, community distress, rurality/urbanicity) on trauma outcomes after controlling for specific injury-related risk factors.
Study Design
All pediatric (age |
| doi_str_mv | 10.1007/s40615-022-01288-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_LD.</sourceid><recordid>TN_cdi_proquest_miscellaneous_2644944230</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2922076420</sourcerecordid><originalsourceid>FETCH-LOGICAL-c419t-eac604f7281ab4e9c78ce037c6782f843f3fbf7f092b0c4648b4d1bb8cf42eb23</originalsourceid><addsrcrecordid>eNp9kMFO3DAQhq2qVUHbfYEeqkhcesDUHju2c6wWWBArqCp6tmxnDEbZZLE3SLw9gaVU4tDTjDTf_DP6CPnK2RFnTP8okileUwZAGQdjaP2B7ANvFDVG6I8vvaZCN7BH5qXcMTZhdd0I9ZnsiVpIrWq2Ty5-u5Bcd1gtsW8xH1aub6tLTDe3fsi3w9DSFT5gVx2nsnE5bROWKvXVL2yT2-YUquvsxrWrFi7jF_Ipuq7g_LXOyJ_Tk-vFGV1dLc8XP1c0SN5sKbqgmIwaDHdeYhO0CciEDkobiEaKKKKPOrIGPAtSSeNly703IUpAD2JGvu9yN3m4H7Fs7TqVgF3nehzGYkFJ2UgJgk3owTv0bhhzP31noQFgWkl4pmBHhTyUkjHaTU5rlx8tZ_bZtt3ZtpNt-2Lb1tPSt9fo0a-xfVv563YCxA4o06i_wfzv9n9inwDvbIhh</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2922076420</pqid></control><display><type>article</type><title>Racial, Gender, and Neighborhood-Level Disparities in Pediatric Trauma Care</title><source>Ethnic NewsWatch (Alumni)</source><creator>Dickens, Harrison ; Rao, Uma ; Sarver, Dustin ; Bruehl, Stephen ; Kinney, Kerry ; Karlson, Cynthia ; Grenn, Emily ; Kutcher, Matthew ; Iwuchukwu, Chinenye ; Kyle, Amber ; Goodin, Burel ; Myers, Hector ; Nag, Subodh ; Hillegass, William B. ; Morris, Matthew C.</creator><creatorcontrib>Dickens, Harrison ; Rao, Uma ; Sarver, Dustin ; Bruehl, Stephen ; Kinney, Kerry ; Karlson, Cynthia ; Grenn, Emily ; Kutcher, Matthew ; Iwuchukwu, Chinenye ; Kyle, Amber ; Goodin, Burel ; Myers, Hector ; Nag, Subodh ; Hillegass, William B. ; Morris, Matthew C.</creatorcontrib><description>Background
Disparities in trauma outcomes and care are well established for adults, but the extent to which similar disparities are observed in pediatric trauma patients requires further investigation. The objective of this study was to evaluate the unique contributions of social determinants (race, gender, insurance status, community distress, rurality/urbanicity) on trauma outcomes after controlling for specific injury-related risk factors.
Study Design
All pediatric (age < 18) trauma patients admitted to a single level 1 trauma center with a statewide, largely rural, catchment area from January 2010 to December 2020 were retrospectively reviewed (
n
= 14,398). Primary outcomes were receipt of opioids in the emergency department, post-discharge rehabilitation referrals, and mortality. Multivariate logistic regressions evaluated demographic, socioeconomic, and injury characteristics. Multilevel logistic regressions evaluated area-level indicators, which were derived from abstracted home addresses.
Results
Analyses adjusting for demographic and injury characteristics revealed that Black children (n = 6255) had significantly lower odds (
OR
= 0.87) of being prescribed opioid medications in the emergency department compared to White children (
n
= 5883). Children living in more distressed and rural communities had greater odds of receiving opioid medications. Girls had significantly lower odds (
OR
= 0.61) of being referred for rehabilitation services than boys. Post hoc analyses revealed that Black girls had the lowest odds of receiving rehabilitation referrals compared to Black boys and White children.
Conclusion
Results highlight the need to examine both main and interactive effects of social determinants on trauma care and outcomes. Findings reinforce and expand into the pediatric population the growing notion that traumatic injury care is not immune to disparities.</description><identifier>ISSN: 2197-3792</identifier><identifier>EISSN: 2196-8837</identifier><identifier>DOI: 10.1007/s40615-022-01288-5</identifier><identifier>PMID: 35347650</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Adult ; Adults ; Aftercare ; Analgesics, Opioid ; Black people ; Catchment areas ; Child ; Children ; Demographics ; Demography ; Design factors ; Emergency medical care ; Emergency Medical Services ; Emergency services ; Epidemiology ; Female ; Gender ; Gender inequality ; Girls ; Health disparities ; Healthcare Disparities ; Hospitals ; Humans ; Inequality ; Injuries ; Injury analysis ; Insurance ; Level indicators ; Male ; Medical referrals ; Medicine ; Medicine & Public Health ; Mortality ; Narcotics ; Neighborhoods ; Opioids ; Patient admissions ; Patient Discharge ; Patients ; Pediatrics ; Psychological distress ; Quality of Life Research ; Race ; Racial differences ; Racial inequality ; Rehabilitation ; Retrospective Studies ; Risk factors ; Risk management ; Rural areas ; Rural communities ; Social factors ; Social Inequality ; Social Structure ; Socioeconomic factors ; Trauma ; Trauma care ; Trauma centers ; Traumatic brain injury ; Underserved populations ; Uninsured people ; United States</subject><ispartof>Journal of racial and ethnic health disparities, 2023-06, Vol.10 (3), p.1006-1017</ispartof><rights>W. Montague Cobb-NMA Health Institute 2022</rights><rights>2022. W. Montague Cobb-NMA Health Institute.</rights><rights>W. Montague Cobb-NMA Health Institute 2022.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-eac604f7281ab4e9c78ce037c6782f843f3fbf7f092b0c4648b4d1bb8cf42eb23</citedby><cites>FETCH-LOGICAL-c419t-eac604f7281ab4e9c78ce037c6782f843f3fbf7f092b0c4648b4d1bb8cf42eb23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40615-022-01288-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2922076420?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,776,780,12719,12798,12825,21367,27901,27902,30976,33721,33722,35782,35783,35787,35788,41464,42533,43781,44305,44306,51294</link.rule.ids><linktorsrc>$$Uhttps://www.proquest.com/docview/2922076420?pq-origsite=primo$$EView_record_in_ProQuest$$FView_record_in_$$GProQuest</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35347650$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dickens, Harrison</creatorcontrib><creatorcontrib>Rao, Uma</creatorcontrib><creatorcontrib>Sarver, Dustin</creatorcontrib><creatorcontrib>Bruehl, Stephen</creatorcontrib><creatorcontrib>Kinney, Kerry</creatorcontrib><creatorcontrib>Karlson, Cynthia</creatorcontrib><creatorcontrib>Grenn, Emily</creatorcontrib><creatorcontrib>Kutcher, Matthew</creatorcontrib><creatorcontrib>Iwuchukwu, Chinenye</creatorcontrib><creatorcontrib>Kyle, Amber</creatorcontrib><creatorcontrib>Goodin, Burel</creatorcontrib><creatorcontrib>Myers, Hector</creatorcontrib><creatorcontrib>Nag, Subodh</creatorcontrib><creatorcontrib>Hillegass, William B.</creatorcontrib><creatorcontrib>Morris, Matthew C.</creatorcontrib><title>Racial, Gender, and Neighborhood-Level Disparities in Pediatric Trauma Care</title><title>Journal of racial and ethnic health disparities</title><addtitle>J. Racial and Ethnic Health Disparities</addtitle><addtitle>J Racial Ethn Health Disparities</addtitle><description>Background
Disparities in trauma outcomes and care are well established for adults, but the extent to which similar disparities are observed in pediatric trauma patients requires further investigation. The objective of this study was to evaluate the unique contributions of social determinants (race, gender, insurance status, community distress, rurality/urbanicity) on trauma outcomes after controlling for specific injury-related risk factors.
Study Design
All pediatric (age < 18) trauma patients admitted to a single level 1 trauma center with a statewide, largely rural, catchment area from January 2010 to December 2020 were retrospectively reviewed (
n
= 14,398). Primary outcomes were receipt of opioids in the emergency department, post-discharge rehabilitation referrals, and mortality. Multivariate logistic regressions evaluated demographic, socioeconomic, and injury characteristics. Multilevel logistic regressions evaluated area-level indicators, which were derived from abstracted home addresses.
Results
Analyses adjusting for demographic and injury characteristics revealed that Black children (n = 6255) had significantly lower odds (
OR
= 0.87) of being prescribed opioid medications in the emergency department compared to White children (
n
= 5883). Children living in more distressed and rural communities had greater odds of receiving opioid medications. Girls had significantly lower odds (
OR
= 0.61) of being referred for rehabilitation services than boys. Post hoc analyses revealed that Black girls had the lowest odds of receiving rehabilitation referrals compared to Black boys and White children.
Conclusion
Results highlight the need to examine both main and interactive effects of social determinants on trauma care and outcomes. Findings reinforce and expand into the pediatric population the growing notion that traumatic injury care is not immune to disparities.</description><subject>Adult</subject><subject>Adults</subject><subject>Aftercare</subject><subject>Analgesics, Opioid</subject><subject>Black people</subject><subject>Catchment areas</subject><subject>Child</subject><subject>Children</subject><subject>Demographics</subject><subject>Demography</subject><subject>Design factors</subject><subject>Emergency medical care</subject><subject>Emergency Medical Services</subject><subject>Emergency services</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Gender</subject><subject>Gender inequality</subject><subject>Girls</subject><subject>Health disparities</subject><subject>Healthcare Disparities</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Inequality</subject><subject>Injuries</subject><subject>Injury analysis</subject><subject>Insurance</subject><subject>Level indicators</subject><subject>Male</subject><subject>Medical referrals</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Narcotics</subject><subject>Neighborhoods</subject><subject>Opioids</subject><subject>Patient admissions</subject><subject>Patient Discharge</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Psychological distress</subject><subject>Quality of Life Research</subject><subject>Race</subject><subject>Racial differences</subject><subject>Racial inequality</subject><subject>Rehabilitation</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Risk management</subject><subject>Rural areas</subject><subject>Rural communities</subject><subject>Social factors</subject><subject>Social Inequality</subject><subject>Social Structure</subject><subject>Socioeconomic factors</subject><subject>Trauma</subject><subject>Trauma care</subject><subject>Trauma centers</subject><subject>Traumatic brain injury</subject><subject>Underserved populations</subject><subject>Uninsured people</subject><subject>United States</subject><issn>2197-3792</issn><issn>2196-8837</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>BENPR</sourceid><sourceid>LD-</sourceid><sourceid>LD.</sourceid><sourceid>QXPDG</sourceid><recordid>eNp9kMFO3DAQhq2qVUHbfYEeqkhcesDUHju2c6wWWBArqCp6tmxnDEbZZLE3SLw9gaVU4tDTjDTf_DP6CPnK2RFnTP8okileUwZAGQdjaP2B7ANvFDVG6I8vvaZCN7BH5qXcMTZhdd0I9ZnsiVpIrWq2Ty5-u5Bcd1gtsW8xH1aub6tLTDe3fsi3w9DSFT5gVx2nsnE5bROWKvXVL2yT2-YUquvsxrWrFi7jF_Ipuq7g_LXOyJ_Tk-vFGV1dLc8XP1c0SN5sKbqgmIwaDHdeYhO0CciEDkobiEaKKKKPOrIGPAtSSeNly703IUpAD2JGvu9yN3m4H7Fs7TqVgF3nehzGYkFJ2UgJgk3owTv0bhhzP31noQFgWkl4pmBHhTyUkjHaTU5rlx8tZ_bZtt3ZtpNt-2Lb1tPSt9fo0a-xfVv563YCxA4o06i_wfzv9n9inwDvbIhh</recordid><startdate>20230601</startdate><enddate>20230601</enddate><creator>Dickens, Harrison</creator><creator>Rao, Uma</creator><creator>Sarver, Dustin</creator><creator>Bruehl, Stephen</creator><creator>Kinney, Kerry</creator><creator>Karlson, Cynthia</creator><creator>Grenn, Emily</creator><creator>Kutcher, Matthew</creator><creator>Iwuchukwu, Chinenye</creator><creator>Kyle, Amber</creator><creator>Goodin, Burel</creator><creator>Myers, Hector</creator><creator>Nag, Subodh</creator><creator>Hillegass, William B.</creator><creator>Morris, Matthew C.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7QJ</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>LD-</scope><scope>LD.</scope><scope>M0S</scope><scope>M2S</scope><scope>NAPCQ</scope><scope>PATMY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PYCSY</scope><scope>QXPDG</scope><scope>7X8</scope></search><sort><creationdate>20230601</creationdate><title>Racial, Gender, and Neighborhood-Level Disparities in Pediatric Trauma Care</title><author>Dickens, Harrison ; Rao, Uma ; Sarver, Dustin ; Bruehl, Stephen ; Kinney, Kerry ; Karlson, Cynthia ; Grenn, Emily ; Kutcher, Matthew ; Iwuchukwu, Chinenye ; Kyle, Amber ; Goodin, Burel ; Myers, Hector ; Nag, Subodh ; Hillegass, William B. ; Morris, Matthew C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-eac604f7281ab4e9c78ce037c6782f843f3fbf7f092b0c4648b4d1bb8cf42eb23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adult</topic><topic>Adults</topic><topic>Aftercare</topic><topic>Analgesics, Opioid</topic><topic>Black people</topic><topic>Catchment areas</topic><topic>Child</topic><topic>Children</topic><topic>Demographics</topic><topic>Demography</topic><topic>Design factors</topic><topic>Emergency medical care</topic><topic>Emergency Medical Services</topic><topic>Emergency services</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Gender</topic><topic>Gender inequality</topic><topic>Girls</topic><topic>Health disparities</topic><topic>Healthcare Disparities</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Inequality</topic><topic>Injuries</topic><topic>Injury analysis</topic><topic>Insurance</topic><topic>Level indicators</topic><topic>Male</topic><topic>Medical referrals</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Narcotics</topic><topic>Neighborhoods</topic><topic>Opioids</topic><topic>Patient admissions</topic><topic>Patient Discharge</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Psychological distress</topic><topic>Quality of Life Research</topic><topic>Race</topic><topic>Racial differences</topic><topic>Racial inequality</topic><topic>Rehabilitation</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Risk management</topic><topic>Rural areas</topic><topic>Rural communities</topic><topic>Social factors</topic><topic>Social Inequality</topic><topic>Social Structure</topic><topic>Socioeconomic factors</topic><topic>Trauma</topic><topic>Trauma care</topic><topic>Trauma centers</topic><topic>Traumatic brain injury</topic><topic>Underserved populations</topic><topic>Uninsured people</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dickens, Harrison</creatorcontrib><creatorcontrib>Rao, Uma</creatorcontrib><creatorcontrib>Sarver, Dustin</creatorcontrib><creatorcontrib>Bruehl, Stephen</creatorcontrib><creatorcontrib>Kinney, Kerry</creatorcontrib><creatorcontrib>Karlson, Cynthia</creatorcontrib><creatorcontrib>Grenn, Emily</creatorcontrib><creatorcontrib>Kutcher, Matthew</creatorcontrib><creatorcontrib>Iwuchukwu, Chinenye</creatorcontrib><creatorcontrib>Kyle, Amber</creatorcontrib><creatorcontrib>Goodin, Burel</creatorcontrib><creatorcontrib>Myers, Hector</creatorcontrib><creatorcontrib>Nag, Subodh</creatorcontrib><creatorcontrib>Hillegass, William B.</creatorcontrib><creatorcontrib>Morris, Matthew C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 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Cynthia</au><au>Grenn, Emily</au><au>Kutcher, Matthew</au><au>Iwuchukwu, Chinenye</au><au>Kyle, Amber</au><au>Goodin, Burel</au><au>Myers, Hector</au><au>Nag, Subodh</au><au>Hillegass, William B.</au><au>Morris, Matthew C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Racial, Gender, and Neighborhood-Level Disparities in Pediatric Trauma Care</atitle><jtitle>Journal of racial and ethnic health disparities</jtitle><stitle>J. Racial and Ethnic Health Disparities</stitle><addtitle>J Racial Ethn Health Disparities</addtitle><date>2023-06-01</date><risdate>2023</risdate><volume>10</volume><issue>3</issue><spage>1006</spage><epage>1017</epage><pages>1006-1017</pages><issn>2197-3792</issn><eissn>2196-8837</eissn><abstract>Background
Disparities in trauma outcomes and care are well established for adults, but the extent to which similar disparities are observed in pediatric trauma patients requires further investigation. The objective of this study was to evaluate the unique contributions of social determinants (race, gender, insurance status, community distress, rurality/urbanicity) on trauma outcomes after controlling for specific injury-related risk factors.
Study Design
All pediatric (age < 18) trauma patients admitted to a single level 1 trauma center with a statewide, largely rural, catchment area from January 2010 to December 2020 were retrospectively reviewed (
n
= 14,398). Primary outcomes were receipt of opioids in the emergency department, post-discharge rehabilitation referrals, and mortality. Multivariate logistic regressions evaluated demographic, socioeconomic, and injury characteristics. Multilevel logistic regressions evaluated area-level indicators, which were derived from abstracted home addresses.
Results
Analyses adjusting for demographic and injury characteristics revealed that Black children (n = 6255) had significantly lower odds (
OR
= 0.87) of being prescribed opioid medications in the emergency department compared to White children (
n
= 5883). Children living in more distressed and rural communities had greater odds of receiving opioid medications. Girls had significantly lower odds (
OR
= 0.61) of being referred for rehabilitation services than boys. Post hoc analyses revealed that Black girls had the lowest odds of receiving rehabilitation referrals compared to Black boys and White children.
Conclusion
Results highlight the need to examine both main and interactive effects of social determinants on trauma care and outcomes. Findings reinforce and expand into the pediatric population the growing notion that traumatic injury care is not immune to disparities.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>35347650</pmid><doi>10.1007/s40615-022-01288-5</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 2197-3792 |
| ispartof | Journal of racial and ethnic health disparities, 2023-06, Vol.10 (3), p.1006-1017 |
| issn | 2197-3792 2196-8837 |
| language | eng |
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| source | Ethnic NewsWatch (Alumni) |
| subjects | Adult Adults Aftercare Analgesics, Opioid Black people Catchment areas Child Children Demographics Demography Design factors Emergency medical care Emergency Medical Services Emergency services Epidemiology Female Gender Gender inequality Girls Health disparities Healthcare Disparities Hospitals Humans Inequality Injuries Injury analysis Insurance Level indicators Male Medical referrals Medicine Medicine & Public Health Mortality Narcotics Neighborhoods Opioids Patient admissions Patient Discharge Patients Pediatrics Psychological distress Quality of Life Research Race Racial differences Racial inequality Rehabilitation Retrospective Studies Risk factors Risk management Rural areas Rural communities Social factors Social Inequality Social Structure Socioeconomic factors Trauma Trauma care Trauma centers Traumatic brain injury Underserved populations Uninsured people United States |
| title | Racial, Gender, and Neighborhood-Level Disparities in Pediatric Trauma Care |
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