Racial disparities in pedestrian-related injury hospitalizations in the United States

Abstract Background. Racial/ethnic disparity has been documented in a wide variety of health outcomes, and environmental components are contributors. For example, food deserts have been tied to obesity rates. Pedestrian injuries are strongly tied to environmental factors, yet no studies have examined racial disparity in pedestrian injury rates. We examine a nationally-representative sample of pedestrian-related hospitalizations in the United States to identify differences in incidence, severity, and cost by race/ethnicity.Methods. Patients with ICD diagnosis E-codes for pedestrian injuries were drawn from the United States Nationwide Inpatient Sample (2009-2016). Rates were calculated using the United States Census. Descriptive statistics and generalized linear regression were used to examine characteristics (age, sex, severity of illness, mortality rates, hospital admissions, length of stay, total costs) associated with hospitalizations for pedestrian injuries.Results. Hospitalization rates were The burden of injury was higher among Black, Hispanic, and Multiracial/Other groups in terms of admission rates, costs per capita, proportion of children injured, and length of stay compared to Whites and Asian or Pacific Islander race/ethnicities. Extreme and major loss of function proportions were also highest among Black and Multiracial/Other groups.Discussion. Results from this study show racial disparities in pedestrian injury hospitalizations and outcomes, particularly among Black, Hispanic, and Multiracial/Other race/ethnicity groups and support population and system-level approaches to prevention. Access to transportation is an indicator for health disparity, and these results indicate that access to safe transportation also shows inequity by race/ethnicity.

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Racial disparities in pedestrian-related injury hospitalizations in the United States

BMC Public Health ◽

10.1186/s12889-020-09513-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Cara Hamann ◽

Corinne Peek-Asa ◽

Brandon Butcher

Keyword(s):

United States ◽

Length Of Stay ◽

Racial Disparities ◽

The United States ◽

Pacific Islanders ◽

Admission Rates ◽

Pedestrian Injury ◽

Race Ethnicity ◽

Per Capita ◽

Pedestrian Injuries

Abstract Background Racial/ethnic disparity has been documented in a wide variety of health outcomes, and environmental components are contributors. For example, food deserts have been tied to obesity rates. Pedestrian injuries are strongly tied to environmental factors, yet no studies have examined racial disparity in pedestrian injury rates. We examine a nationally-representative sample of pedestrian-related hospitalizations in the United States to identify differences in incidence, severity, and cost by race/ethnicity. Methods Patients with ICD diagnosis E-codes for pedestrian injuries were drawn from the United States Nationwide Inpatient Sample (2009–2016). Rates were calculated using the United States Census. Descriptive statistics and generalized linear regression were used to examine characteristics (age, sex, severity of illness, mortality rates, hospital admissions, length of stay, total costs) associated with hospitalizations for pedestrian injuries. Results The annual average of pedestrian-related deaths exceeded 5000 per year and hospitalizations exceeded 47,000 admissions per year. The burden of injury from pedestrian-related hospitalizations was higher among Black, Hispanic, and Multiracial/Other groups in terms of admission rates, costs per capita, proportion of children injured, and length of stay compared to Whites and Asian or Pacific Islander race/ethnicities. Compared to Whites, hospital admission rates were 1.92 (95% CI: 1.89–1.94) and 1.20 (95% CI: 1.19–1.21) times higher for Multiracial/Other and Blacks, respectively. Costs per capita ($USD) were $6.30, $4.14, and $3.22 for Multiracial/Others, Blacks, and Hispanics, compared to $2.88 and $2.32 for Whites and Asian or Pacific Islanders. Proportion of lengths of stay exceeding one week were larger for Blacks (26.4%), Hispanics (22.6%), Asian or Pacific Islanders (23.1%), and Multiracial/Other (24.1%), compared to Whites (18.6%). Extreme and major loss of function proportions were also highest among Black (34.5%) and lowest among Whites (30.2%). Conclusions Results from this study show racial disparities in pedestrian injury hospitalization rates and outcomes, particularly among Black, Hispanic, and Multiracial/Other race/ethnicity groups and support population and system-level approaches to prevention. Access to transportation is an indicator for health disparity, and these results indicate that access to safe transportation also shows inequity by race/ethnicity.

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Racial disparities in pedestrian-related injury hospitalizations in the United States

10.21203/rs.3.rs-15658/v2 ◽

2020 ◽

Author(s):

Cara Hamann ◽

Corinne Peek-Asa ◽

Brandon Butcher

Keyword(s):

United States ◽

Length Of Stay ◽

Racial Disparities ◽

The United States ◽

Pacific Islanders ◽

Admission Rates ◽

Pedestrian Injury ◽

Race Ethnicity ◽

Per Capita ◽

Pedestrian Injuries

Abstract Background. Racial/ethnic disparity has been documented in a wide variety of health outcomes, and environmental components are contributors. For example, food deserts have been tied to obesity rates. Pedestrian injuries are strongly tied to environmental factors, yet no studies have examined racial disparity in pedestrian injury rates. We examine a nationally-representative sample of pedestrian-related hospitalizations in the United States to identify differences in incidence, severity, and cost by race/ethnicity.Methods. Patients with ICD diagnosis E-codes for pedestrian injuries were drawn from the United States Nationwide Inpatient Sample (2009-2016). Rates were calculated using the United States Census. Descriptive statistics and generalized linear regression were used to examine characteristics (age, sex, severity of illness, mortality rates, hospital admissions, length of stay, total costs) associated with hospitalizations for pedestrian injuries.Results. The burden of injury from pedestrian-related hospitalizations was higher among Black, Hispanic, and Multiracial/Other groups in terms of admission rates, costs per capita, proportion of children injured, and length of stay compared to Whites and Asian or Pacific Islander race/ethnicities. Compared to Whites, hospital admission rates were 1.92 (95% CI: 1.89-1.94) and 1.20 (95% CI: 1.19-1.21) times higher for Multiracial/Other and Blacks, respectively. Costs per capita ($USD) were $6.30, $4.14, and $3.22 for Multiracial/Others, Blacks, and Hispanics, compared to $2.88 and $2.32 for Whites and Asian or Pacific Islanders. Proportion of lengths of stay exceeding one week were larger for Blacks (26.4%), Hispanics (22.6%), Asian or Pacific Islanders (23.1%), and Multiracial/Other (24.1%), compared to Whites (18.6%). Extreme and major loss of function proportions were also highest among Black (34.5%) and lowest among Whites (30.2%).Discussion. Results from this study show racial disparities in pedestrian injury hospitalization rates and outcomes, particularly among Black, Hispanic, and Multiracial/Other race/ethnicity groups and support population and system-level approaches to prevention. Access to transportation is an indicator for health disparity, and these results indicate that access to safe transportation also shows inequity by race/ethnicity.

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Racial disparities in pedestrian-related injury hospitalizations in the United States

10.21203/rs.3.rs-15658/v4 ◽

2020 ◽

Author(s):

Cara Hamann ◽

Corinne Peek-Asa ◽

Brandon Butcher

Keyword(s):

United States ◽

Length Of Stay ◽

Racial Disparities ◽

The United States ◽

Pacific Islanders ◽

Admission Rates ◽

Pedestrian Injury ◽

Race Ethnicity ◽

Per Capita ◽

Pedestrian Injuries

Abstract BackgroundRacial/ethnic disparity has been documented in a wide variety of health outcomes, and environmental components are contributors. For example, food deserts have been tied to obesity rates. Pedestrian injuries are strongly tied to environmental factors, yet no studies have examined racial disparity in pedestrian injury rates. We examine a nationally-representative sample of pedestrian-related hospitalizations in the United States to identify differences in incidence, severity, and cost by race/ethnicity.MethodsPatients with ICD diagnosis E-codes for pedestrian injuries were drawn from the United States Nationwide Inpatient Sample (2009-2016). Rates were calculated using the United States Census. Descriptive statistics and generalized linear regression were used to examine characteristics (age, sex, severity of illness, mortality rates, hospital admissions, length of stay, total costs) associated with hospitalizations for pedestrian injuries.ResultsThe burden of injury from pedestrian-related hospitalizations was higher among Black, Hispanic, and Multiracial/Other groups in terms of admission rates, costs per capita, proportion of children injured, and length of stay compared to Whites and Asian or Pacific Islander race/ethnicities. Compared to Whites, hospital admission rates were 1.92 (95% CI: 1.89-1.94) and 1.20 (95% CI: 1.19-1.21) times higher for Multiracial/Other and Blacks, respectively. Costs per capita ($USD) were $6.30, $4.14, and $3.22 for Multiracial/Others, Blacks, and Hispanics, compared to $2.88 and $2.32 for Whites and Asian or Pacific Islanders. Proportion of lengths of stay exceeding one week were larger for Blacks (26.4%), Hispanics (22.6%), Asian or Pacific Islanders (23.1%), and Multiracial/Other (24.1%), compared to Whites (18.6%). Extreme and major loss of function proportions were also highest among Black (34.5%) and lowest among Whites (30.2%).ConclusionsResults from this study show racial disparities in pedestrian injury hospitalization rates and outcomes, particularly among Black, Hispanic, and Multiracial/Other race/ethnicity groups and support population and system-level approaches to prevention. Access to transportation is an indicator for health disparity, and these results indicate that access to safe transportation also shows inequity by race/ethnicity.

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Racial disparities in pedestrian-related injury hospitalizations in the United States

10.21203/rs.3.rs-15658/v3 ◽

2020 ◽

Author(s):

Cara Hamann ◽

Corinne Peek-Asa ◽

Brandon Butcher

Keyword(s):

United States ◽

Length Of Stay ◽

Racial Disparities ◽

The United States ◽

Pacific Islanders ◽

Admission Rates ◽

Pedestrian Injury ◽

Race Ethnicity ◽

Per Capita ◽

Pedestrian Injuries

Abstract Background. Racial/ethnic disparity has been documented in a wide variety of health outcomes, and environmental components are contributors. For example, food deserts have been tied to obesity rates. Pedestrian injuries are strongly tied to environmental factors, yet no studies have examined racial disparity in pedestrian injury rates. We examine a nationally-representative sample of pedestrian-related hospitalizations in the United States to identify differences in incidence, severity, and cost by race/ethnicity.Methods. Patients with ICD diagnosis E-codes for pedestrian injuries were drawn from the United States Nationwide Inpatient Sample (2009-2016). Rates were calculated using the United States Census. Descriptive statistics and generalized linear regression were used to examine characteristics (age, sex, severity of illness, mortality rates, hospital admissions, length of stay, total costs) associated with hospitalizations for pedestrian injuries.Results. The annual average of pedestrian-related deaths exceeded 5,000 per year and hospitalizations exceeded 47,000 admissions per year. The burden of injury from pedestrian-related hospitalizations was higher among Black, Hispanic, and Multiracial/Other groups in terms of admission rates, costs per capita, proportion of children injured, and length of stay compared to Whites and Asian or Pacific Islander race/ethnicities. Compared to Whites, hospital admission rates were 1.92 (95% CI: 1.89-1.94) and 1.20 (95% CI: 1.19-1.21) times higher for Multiracial/Other and Blacks, respectively. Costs per capita ($USD) were $6.30, $4.14, and $3.22 for Multiracial/Others, Blacks, and Hispanics, compared to $2.88 and $2.32 for Whites and Asian or Pacific Islanders. Proportion of lengths of stay exceeding one week were larger for Blacks (26.4%), Hispanics (22.6%), Asian or Pacific Islanders (23.1%), and Multiracial/Other (24.1%), compared to Whites (18.6%). Extreme and major loss of function proportions were also highest among Black (34.5%) and lowest among Whites (30.2%).Discussion. Results from this study show racial disparities in pedestrian injury hospitalization rates and outcomes, particularly among Black, Hispanic, and Multiracial/Other race/ethnicity groups and support population and system-level approaches to prevention. Access to transportation is an indicator for health disparity, and these results indicate that access to safe transportation also shows inequity by race/ethnicity.

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Role of Disease-Specific Incidence and Survival in Disparities in Life Expectancy in the United States

Innovation in Aging ◽

10.1093/geroni/igab046.571 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 149-149

Author(s):

Julia Kravchenko ◽

Bin Yu ◽

Igor Akushevich

Keyword(s):

United States ◽

Lung Cancer ◽

Life Expectancy ◽

Racial Disparities ◽

Disease Incidence ◽

The United States ◽

The State ◽

The Us ◽

Race Ethnicity ◽

Disease Specific

Abstract There are persisting geographic and racial disparities in life expectancy (LE) across the United States (US). We used 5% Medicare Claims data (2000-2017) to investigate how disease incidence and survival contribute to such disparities. Disease-specific hazard ratios (HRs) were calculated for Medicare beneficiaries living in the US states with the lowest LE (the states with the highest LE were used as a reference group), in gender- and race-/ethnicity-specific populations. Analysis of incidence showed that the greatest contribution to between-the-state disparities in LE was due to higher incidence (HRs≥1.30) of atherosclerosis, heart failure, influenza/pneumonia, Alzheimer’s disease, and lung cancer among older adults living in the states with the lowest LE. The list of diseases that contributed most to LE through the differences in their survival substantially differed from the above listed diseases: namely, diabetes, chronic ischemic heart disease, and cerebrovascular disease had HRs≥1.28 for their respective survival rates, with the highest HRs for lung cancer (HR=1.37, in females) and prostate cancer (HR=1.30). Respective race-/ethnicity-specific patterns of incidence and survival HRs were investigated and diseases contributed most to racial disparities in LE were identified. Study showed that when planning the strategies targeting between-the-state differences in LE in the US, it is important to address both 1) primary and secondary prevention for diseases demonstrating substantial differences in contributions of incidence, and 2) treatment choice, adherence to treatment, and comorbidities for diseases contributing to LE disparities predominantly through the differences in survival. Such strategies can be disease-, race-/ethnicity-, and geographic area-specific.

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Inpatient burden of esophageal cancer and analysis of factors affecting in-hospital mortality and length of stay

Diseases of the Esophagus ◽

10.1093/dote/doy022 ◽

2018 ◽

Vol 31 (9) ◽

Cited By ~ 1

Author(s):

S Sarvepalli ◽

S K Garg ◽

S S Sarvepalli ◽

M P Parikh ◽

V Wadhwa ◽

...

Keyword(s):

United States ◽

Esophageal Cancer ◽

Length Of Stay ◽

Clinical Decision Making ◽

Hospital Admissions ◽

The United States ◽

Hospital Utilization ◽

Inpatient Mortality ◽

Factors Associated ◽

Hospital Stays

Summary Esophageal cancer (EC) continues to be a major source of morbidity and mortality in the United States. However, there has been a relative dearth of research into hospital utilization in patients with EC. This study examines temporal trends in hospital admissions, length of stay (LOS), mortality, and costs associated with EC. In addition, we also analyzed factors associated with inpatient mortality and LOS. We interrogated National Inpatient Sample (NIS), a large registry of inpatient data, to retrieve information about various demographic and factors associated with hospital stay in patients who were admitted for EC between the years 1998 and 2013 in the United States. After examining trends over time, multivariate analysis was performed to identify factors associated with LOS and mortality. During 1998–2013, 538,776 hospital stays with principal diagnosis of EC were reviewed. Number of hospital stays and inpatient charges increased by 397 per year (±67.8;P < 0.0001) and $3,033 per patient per year (±135; <0.0001) respectively. Mortality and LOS decreased by 0.23% per year (±0.03;P < 0.0001) and 0.07 days per year (±0.006;P < 0.0001) respectively. Multiple factors associated with LOS and mortality were outlined. Despite overall increase in hospital utilization with respect to number of admissions and inpatient charges, inpatient mortality and LOS associated with EC declined. Factors associated with inpatient mortality and LOS may help drive clinical decision-making and influence healthcare or hospital policy.

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The Role of Income and Race/Ethnicity in Experiences with Medical Care in the United States and United Kingdom

International Journal of Health Services ◽

10.2190/hs.38.4.f ◽

2008 ◽

Vol 38 (4) ◽

pp. 671-695 ◽

Cited By ~ 10

Author(s):

Jason Schnittker ◽

Mehul Bhatt

Keyword(s):

United States ◽

Primary Care ◽

Health Care ◽

United Kingdom ◽

Health Insurance ◽

Medical Care ◽

Health Care Systems ◽

The United States ◽

System Level ◽

Race Ethnicity

Inequalities in experiences with medical care are well-known in the United States, but little is known about the shape of such inequalities in other countries. This study compares a broad spectrum of experiences in the United States and United Kingdom. Furthermore, it focuses on two of the most important dimensions of inequality, race/ethnicity and income, and two of the most widely discussed system-level factors, health insurance and emphasis on primary care. Two general conclusions are reached. First, there are broad income-based inequalities in medical care in both the United States and United Kingdom. These inequalities persist even after controlling for health insurance, including private medical insurance in the United Kingdom. Race is also related to experiences with medical care, although the effects of race are more particular and contingent than are those for income. In particular, the mapping of racial/ethnic inequality differs considerably between the United States and United Kingdom, reflecting their different sociocultural climates. Second, the health care system, especially primary care, plays a limited role in ameliorating inequalities in care, but plays a strong role in elevating the average level of quality within a country. Because inequalities in medical care reflect broader social processes, they are durable across very different health care systems and contexts.

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