276 - Opportunity Divides: Exploring the Role of Social Environment in Pediatric Trauma Outcomes

Publication Number: 2266.276

Yomayra Perez Morel, University of New Mexico School of Medicine, albuquerque, NM, United States; Lynne Fullerton, University of New Mexico School of Medicine, Albuquerque, NM, United States; Tara Neubrand, University of New Mexico School of Medicine, Albuquerque, NM, United States; Richard Miskimins, University of New Mexico, Albuquerque, NM, United States

Background: Injury is the primary cause of pediatric mortality, and the rate of violence-related injuries has been rising since 2020. In New Mexico, unintentional injuries were the leading cause of child deaths from 2011 to 2021, and NM rates consistently exceed the national average.

Objective: The purpose of this study is to examine the relationship between Child Opportunity Index (COI) scores and trauma severity and type. If geographic patterns are identified, it will allow for informed prevention strategies and policy implementation in regions found to be at elevated risk of trauma.

Design/Methods: This cross-sectional analysis links data from the University of New Mexico (UNM) Trauma Database and the Child Opportunity Index (COI) 3.0. The UNM Trauma Database captures emergency department (ED) visits for all trauma except poisonings, drownings, and suffocation. The COI data use 44 separate components from education, health and environment, and social and economic domains. These are weighted and combined to create a composite score measuring opportunities provided to children where they live.
Study inclusion criteria were age < 19 years and ED visit date from 1/1/2017-12/31/2022. We compared NM state-normalized COI scores to measures of injury severity and type: Glasgow Coma Scale scores, Injury Severity Scale scores, number of ICU days, inpatient days, ventilator days, and injury mechanism. The chi-square test was used to test statistical relationships with 0.05 as the threshold for significance.

Results: COI is negatively associated with several measures of trauma severity (Table 2). These include number of days in the hospital, number of days in the intensive care unit (ICU), number of days on a ventilator, and GCS score < 15. COI was also negatively associated with hospital discharge disposition, with children in lower COI neighborhoods more likely to be discharged with moderate or severe disability than those from high or very high COI neighborhoods.

Conclusion(s): This study demonstrates a strong association between COI and several measures of trauma severity among New Mexico's children. These findings can be used to generate evidence-based recommendations for policy formulation and targeted interventions to improve safety and mitigate trauma within identified areas.

Distribution of patients represented in NM Trauma Registry Database, 2017-2022 linked with 2022 Child Opportunity Index database highlighting demographic variables (N=2,284)
The linked NM Trauma Registry and COI datasets resulted in 2,284 records. Distributions of patients by age group, sex, and race/ethnicity are presented in Table 1.

Hypothesis test for Injury mechanism and Severity for injuries reported to NM Trauma Registry Database, 2017-2022, as associated with state normalized COI levels (2399)