Geospatial analysis of community-level social and environmental barriers for adult burn injury survivors in North Texas.

Abstract

This study investigates geographic variations in community integration among burn injury survivors in North Texas and identifies community-level social and environmental factors that influence their post-injury community reintegration. We utilized data from the Burn Model System (BMS) National Database, focusing on 153 adult burn injury survivors in North Texas who sustained injuries between 2015 and 2022. We conducted county-level mapping to visualize temporal changes in Community Integration Questionnaire (CIQ) scores by comparing pre-injury scores to post-injury scores at 6 and 12 months. Next, we categorized counties into two groups: (1) counties with consistent declines in CIQ scores over the 12-month post-injury period, and (2) all other counties with burn injury survivors. We then compared county-level community characteristics between these two groups, focusing on four factors: socioeconomic conditions, access to healthcare, public safety, and the built environment. There were geographic disparities in CIQ score changes among counties after burn injury. Counties with consistent decreases in CIQ scores had significantly higher levels of poverty, higher unemployment rates, increased crime rates, and lower access to healthy food options compared to other counties. The findings suggest that rural counties may lack a supportive environment for burn injury survivors, highlighting the need for targeted interventions to promote community integration. Implementing strategies to reduce socioeconomic disparities, enhance public safety, and improve access to nutritious food could help facilitate better community reintegration outcomes for burn injury survivors. Furthermore, clinicians can leverage these insights by offering patient-level supports-such as localized telehealth services, peer support group referrals at discharge, and guidance on local resources-to help individuals navigate environmental barriers and maintain community engagement after returning home.