# Health Equity in Emergency Trauma Care: Analysis of disparities in the pre-hospital emergency trauma care system

> **NIH NIH R01** · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · 2024 · $588,563

## Abstract

PROJECT SUMMARY/ABSTRACT
Trauma is the leading cause of death for children and adults 46 years and younger, killing more Americans
than AIDS and stroke combined. African Americans (OR 1.2, P<0.001), people living in high poverty
neighborhoods (OR 1.01, P<0.001), and those enrolled in public health insurance programs (OR 1.53,
P<0.001) have increased mortality after trauma when compared to their injured counterparts. Quantifying
the equity in access to Emergency Medical Services (EMS) and designated/verified trauma centers (TCs), as
well as the extent to which timely access to care improves health outcomes are critical first steps to address
this alarming discrepancy. Equitable availability to EMS has yet to be evaluated and equitable access to TCs is
understudied. In fact, no one has explored the importance of expeditious availability to emergency health care
services such as EMS and timely access to emergent trauma care as key social determinants of health
(SDOH). Models to evaluate the role of SDOH as major predictors of these disparities remain untested. Rapid
transport to a TC is associated with a 25% reduction in mortality; however, nearly 45 million Americans lack
timely access to a verified TC. When compared to white populations, recent data show racial/ethnic minority
populations have significantly less access to TC and worse outcomes following trauma. Understanding
the factors that determine trauma-related socio-spatial disparities can inform interventions at both the policy
and system levels to mitigate the disproportionately large numbers of deaths experienced by minoritized
populations. Thus, there is a compelling need for research in these areas to facilitate targeted interventions to
eliminate socio-spatial disparities within the pre-hospital phase of the emergency trauma care system to
improve patient outcomes. To evaluate socio-spatial disparities in availability and access to both EMS and to
TCs among critically injured trauma patients, we will apply the Health Equity Measurable Framework (HEMF)
to the pre-hospital phase of the emergency trauma care system (availability to EMS, EMS response time,
EMS scene time, EMS transportation time, EMS decision to transport to TCs vs. non-TCs, and EMS total
prehospital time) and use large national databases to develop spatiotemporal models to assess drivers of
disparities in traumatic injuries. HEMF will be particularly well suited for our proposed study because it is
designed to describe SDOH in a causal framework to guide the quantitative analysis of health equity for
ongoing pre-hospital trauma care surveillance of the critically injured and subsequent policy development. Our
interdisciplinary team will use data science methods and novel analytics to address this critical public health
need by identifying health disparities at the level of the pre-hospital emergency trauma care system.

## Key facts

- **NIH application ID:** 10887390
- **Project number:** 5R01MD018177-02
- **Recipient organization:** NEW YORK UNIVERSITY SCHOOL OF MEDICINE
- **Principal Investigator:** Cherisse Danielle Berry
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $588,563
- **Award type:** 5
- **Project period:** 2023-07-13 → 2024-11-14

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10887390

## Citation

> US National Institutes of Health, RePORTER application 10887390, Health Equity in Emergency Trauma Care: Analysis of disparities in the pre-hospital emergency trauma care system (5R01MD018177-02). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10887390. Licensed CC0.

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