Association between neighborhood opportunity and incidence of pediatric trauma.

Abstract

To describe the epidemiology of pediatric trauma and its association with neighborhood opportunity in a large, urban metropolitan area. This was a multicenter, retrospective, cross-sectional study of pediatric trauma activations in Los Angeles (LA) County between 2010 and 2021. Children under 18 years old with a home zip code in LA County were eligible. Our main exposure was the categorical Child Opportunity Index 2.0 (COI) score for a child's home zip code. The primary outcome was trauma activations per 100,000 children. Our secondary outcomes were variation in injury mechanism, severity and disposition by COI. The final sample was comprised of 28,034 patients. The median age was 13.0 years (IQR 7.0, 16.0). Mortality was 1.8% (n = 493). Overall, geographic areas with lower COI overlapped with areas of higher trauma incidence. Falls and sports-related injuries were more common in higher COI areas (all p < 0.001). Conversely, being a pedestrian or bicyclist struck, firearm injuries and assaults/stabbings were more common in lower COI areas (all p < 0.001). The incidence of pediatric trauma varies based on the COI of a child's home zip code. Our findings can help inform resource allocation for injury prevention programs targeted to specific neighborhoods at greatest risk.