Race correlated with death rates in pedestrians hit by cars

According to new research from the Hopkins School of Medicine, published in the August edition of Surgery, the risk of death for pedestrians increases significantly if they are uninsured and belong to the minority population. Their study has significant implications about disparities in outcomes after treatment for medical conditions in general.

Two years ago, this team of researchers was one of the first to categorically demonstrate the increased likelihood of death after traumatic injury of minorities and uninsured patients.

This finding was surprising, as they had assumed that all patients admitted into an emergency room would be treated in similar ways.

However, their results demonstrated that this was not the case. The latest research is part of a series of investigations that the team is working on to better understand the reasons underlying such disparate outcomes.

Minorities already face problems such as higher death rates due to motor vehicle accidents, according to data from the Federal Government.

However, this problem is not simply due to an increased susceptibility of being hit. Rather, the fact that they are minorities may correlate to an increased likelihood of death after the accident. The same goes for those without health insurance. The problem is compounded if a patient both has minority status and is uninsured.

Adil Haider, assistant professor of surgery at the School of Medicine and the senior author of the paper, explained.

“If there are two patients and they have the same injuries after being struck by a car, we found that if the person is black, they are 22 percent more likely to die, and if they are Hispanic, they are 33 percent more likely to die, compared to an equivalently injured white patient,” he said.

In addition, if the patient happens to be uninsured, he or she is 77 percent more likely to die after the accident.

The study makes significant strides in the relatively new field of health care disparities, but there are many factors that have yet to be explored. “This kind of work ends up generating more questions than answers,” Haider said. “We now know that the emergency room is not the ‘great equalizer’ and we need to find out why.”

The researchers hope that, as a result of their research, they can create interventions to reduce or eventually eliminate these disparities. In the meantime, Haider proposes a common sense solution: “To direct resources towards injury prevention programs targeted towards pedestrian safety, so that we can prevent these injuries and deaths in the first place.” He adds that a good place to start would be the inner cities, as they are the sites of most crashes.

Their findings are not limited to pedestrian safety. “I just would like to get the message across that disparities in outcomes after treatment for almost any medical condition are real,” Haider said. “We need to find out why and do something about it.”

Also involved in the study were Rubie Sue Maybury, Oluwaseyi Bolorunduro, Cassandra Villegas, Elliott Haut, Kent Stevens, Edward Cornwell III and David Efron, from the Hopkins School of Medicine, the Georgetown University Hospital and the Howard University Hospital.