Page 15 - Delaware Medical Journal - July 2016
P. 15
SCIENTIFIC ARTICLE
IntroductionMotor vehicle crashes are the leading cause of unintentional deaths in people aged 5–25 years.1 In 2006, as much as 25 percent of children and adolescents who were killed in motor vehicle crashes in the United States were pedestrians. Many data have shown that these crashes tend to be clustered in urban areas where larger proportions of children and adolescents are minorities and are of lower socioeconomic status.2 2 of pedestrian injuries events involving pediatric patients occurred disproportionately in neighborhoods with lower income levels and higher percentages of African Americans. Besides the demographics of the population, there are many other factors that put children in low income neighborhoods at high risk of injury, such as speed limits in school zones, proximity to major highways and interstates, available playgrounds and recreational facilities, crossing guards, street likely result from a combination of these factors. In addition, some which makes the development of appropriately targeted prevention 3-7
Recently, geographic information system (GIS) software (Esri, Redlands, CA) has been used to spatially analyze the occurrence
of pedestrian injury and how it relates to intrinsic, extrinsic, and environmental factors. This software can locate “hot spots” of where pedestrian injuries tend to occur. Moreover, it can identify risk factors unique to an area that may put young pedestrians at risk for motor vehicle crashes.8 At our hospital, we have noticed that pediatric trauma patients are struck by motor vehicles with more frequency in certain parts of the state. As the sole tertiary care provider for pediatric trauma patients, it is our goal to develop and implement focused prevention strategies and community-based interventions to ensure the safety and well-being of the children and adolescents of our state. The purpose of our study was to use GIS software to perform a retrospective analysis to examine the relationship between the frequency of children involved in motor vehicle pedestrian crashes, geographic location of these injury events, and socio-demographic factors (age, sex, race, education level, median income, etc.) of the regions in which these injury events occurred.
MATERIALS AND METHODS
With approval from the institutional review board at our hospital, we reviewed data from our prospectively maintained trauma registry for the state of Delaware from January 1, 2002, to
FIGURE 2
Analysis of accidents by distribution of African American population within Delaware. The top panel shows a map indicating the African American population by census tract in Delaware. Key areas of concentration include Wilmington in the north and Dover in the middle of the state. The bottom panel shows ANOVA comparison of normalized accident frequency across quintiles of population. Stars are placed atop bars if that quintile is significantly different from the others indicated. Where only a single difference is noted, the star may be placed between the connector. Double stars (**) indicate a significant difference as per the BH correction, whereas single stars (*) indicate a difference at the P < 0.05 level. Census tracts with the highest African American populations also have significantly higher accident rates.
Del Med J | July 2016 | Vol. 88 | No. 7
207
