A population-based analysis of socioeconomic status and insurance status and their relationship with pediatric trauma hospitalization and mortality rates

Objectives. We investigated socioeconomic disparities in injury hospitalization rates and severity-adjusted mortality for pediatric trauma. Methods. We used 10 years of pediatric trauma data from Sacramento County, Calif, to compare trauma hospitalization rates, trauma mechanism and severity, and standardized hospital mortality across socioeconomic strata (median household income, proportion of households in poverty, insurance). Results. Children from lower-socioeconomic status (SES) communities had higher injury hospitalization and mortality rates, and presented more frequently with more lethal mechanisms of injury (pedestrian, firearm), but did not have higher severity-adjusted mortality. Conclusions. Higher injury mortality rates among children of lower SES in Sacramento County are explained by a higher incidence of trauma and more fatal mechanisms of injury, not by greater injury severity or poorer inpatient care.