Race Plays Role In Pedestrian Vs. Car Accidents
BALTIMORE, MD - Uninsured minority pedestrians hit by cars are at a significantly
higher risk of death than their insured white counterparts, even if
the injuries sustained are similar, new research from Johns Hopkins suggests.
The death rate disparity is compounded by the fact that minority
pedestrians are far more likely than white pedestrians to be struck
by motor vehicles, according to a study published in the August issue
of the journal Surgery.
"It's a double whammy," says Adil H. Haider, M.D., M.P.H., an
assistant professor of surgery at the Johns Hopkins University School
of Medicine and the study's senior author. "Minorities are much more
likely to get injured by this mechanism and much more likely to die
by this mechanism."
Haider and Rubie Sue Maybury, M.D., M.P.H., reviewed National Trauma
Data Bank information on 26,404 patients hit by vehicles between 2002
and 2006. African-American patients had a 22 percent greater risk of
death and Hispanic patients a 33 percent greater risk of death than
white patients involved in similar crashes. Meanwhile, the
researchers said, uninsured patients had a 77 percent greater risk of
death than those who were insured, even though the care they received
was in emergency departments, long believed to be a great equalizer
in health care delivery.
The greater mortality rates from pedestrian trauma in minorities and
the uninsured are not accounted for by greater rates of injury, Haider says.
"Do we treat minorities and the uninsured differently? I don't think
so, but we've got to ask the question," says Haider, who is also
co-director of the Johns Hopkins Center for Surgical Trials and
Outcomes Research. "We don't actually know what is leading to these
Previous studies have shown that insurance status and race may
increase mortality risk because of treatment delay or differences in
services provided. A greater prevalence of, or lack of treatment for,
comorbidities, such as obesity, diabetes or hypertension, could be
factors that raise the risk of death among injured minority or
uninsured crash victims.
Since the underlying causes of the disparities can't be easily
answered, Haider says, policy makers need to focus in the short term
on better pedestrian injury-prevention programs, particularly in the
inner city, where many of these deadly crashes occur. He points to
successes in getting people to use seat belts and in getting parents
to put their children in safety seats - two innovations that have
saved many lives. He concedes, however, that the problem of
pedestrian injury may be more complicated.
Other Johns Hopkins researchers who worked on this study are
Cassandra Villegas; Elliott R. Haut, M.D.; Kent Stevens, M.D.,
M.P.H.; and David T. Efron, M.D.