Inj Epidemiol. 2025 Jul 7;12(Suppl 1):39. doi: 10.1186/s40621-025-00598-6.
ABSTRACT
BACKGROUND: Unintentional injuries, including traumatic brain injuries (TBI) during activities where helmet usage is recommended (AWHUR), are a leading cause of pediatric morbidity and mortality in the U.S. While advocacy and education are proven measures to address safety, community resources in a child’s neighborhood are known to have a large impact on their health.
METHODS: We utilized the trauma registry at two pediatric trauma centers, in a major metropolitan area from 2018 to 2022, to perform a retrospective chart review and Geographical Information System (GIS) mapping on all AWHUR injuries that were included in the trauma registry. Data extracted from the trauma registry included: mechanism, demographics, insurance status, and injury characteristics. AWHUR data was then overlaid with the Childhood Opportunity Index (COI) to assess community resources in relation to injury characteristics.
RESULTS: Our sample size included 1425 children throughout the 5-year time period. The most common injury mechanisms included: bicycle 34.0%, ATV 18.2%, skateboard 13.3%, scooter 9.2%, and dirt-bike 7.4%. Most patients in very low and low COI were publicly insured, respectively 81.9% and 63.2%; while 65.8% of high COI injured patients were privately insured children. There was a statistically significant difference in helmet usage across different levels of COI (p < 0.001). The rates of helmet usage by COI ranking from very low to very high were as follows: 21.6%, 25.2%, 37.8%, 40.2%, and 51.6% utilization. Among those injured while wearing a helmet, the odds of sustaining a higher ISS were 34% lower (OR = 0.66, 95% CI: 0.50-0.89) compared to those who were not wearing a helmet at the time of injury. Additionally, GIS mapping identified low and very low COI communities with higher injury rates and lower helmet use.
CONCLUSION: Children with lower COI were more likely to be publicly insured with a lower percentage of helmet usage. Overlapping injury data and COI identified high-risk communities where low resources can contribute to growing injury severity. This data can then be used to inform injury prevention and highlight the importance of community factors.
PMID:40624603 | DOI:10.1186/s40621-025-00598-6
