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Open Access

Describing the density of high-level trauma centers in the 15 largest US cities

Anne M Stey, Alexandria Byskosh, Caryn Etkin, Robert Mackersie, Deborah M Stein, Karl Y Bilimoria, Marie L Crandall
DOI: 10.1136/tsaco-2020-000562 Published 9 October 2020
Anne M Stey
1Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Alexandria Byskosh
1Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Caryn Etkin
1Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Robert Mackersie
2Department of Surgery, University of California San Francisco, San Francisco, California, USA
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Deborah M Stein
3R Adams Cowley Shock Trauma Center, San Francisco, California, USA
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Karl Y Bilimoria
1Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Marie L Crandall
4Department of Surgery, University of Florida College of Medicine – Jacksonville, Jacksonville, Florida, USA
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  • Figure 1
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    Figure 1

    Urban trauma center density. Plots the level 1 and 2 trauma centers in 8 of the largest 15 cities in the USA. Colored polygons represent 20 min drive radius of the level 1 trauma centers. Online supplemental materials include all cities mapped.

Tables

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  • Table 1

    Demographics of largest 15 US metropolitan areas

    PopulationSize (km2)Population density (person/km2)High-level trauma centersHigh-level center population density (person/center)High-level center geographic density (km2/center)
    New York8 443 713485.117406.116527 73230.3
    Los Angeles3 990 4694754.15291.714285 03453.9
    Chicago2 705 988365.87397.510270 59936.6
    Houston2 295 9821025.82238.24573 996256.5
    Phoenix1 610 071832.81933.39178 89792.5
    Philadelphia1 575 522215.87300.87225 07530.8
    San Antonio1 486 521741.72004.22743 261370.9
    San Diego1 401 932523.22679.54350 483130.8
    Dallas1 318 806548.52404.47188 40178.4
    San Jose1 026 658285.73593.53342 21995.2
    Austin935 755503.21859.64233 939125.8
    Jacksonville878 9071202.5730.94219 727300.6
    San Francisco870 04475.511523.81870 04475.5
    Columbus867 628351.52468.44216 90787.9
    Indianapolis857 637581.61474.63285 879193.9
    • All demographic data were estimates from 2018.

  • Table 2

    Demographics and social determinants of health by metropolitan area

    Median age (years)Gender
    (% female)
    Median income ($)Educational attainment* (%)Poverty rate (%)Unemployment rate (%)
    New York37.948.360 76281.618.93.6
    Los Angeles35.850.058 38577.019.14.0
    Chicago34.951.255 19884.519.55.5
    Houston32.950.451 14078.320.63.6
    Phoenix33.550.354 76581.519.43.3
    Philadelphia34.552.643 74483.924.95.0
    San Antonio33.750.350 98082.018.63.8
    San Diego35.449.575 45687.913.83.5
    Dallas32.750.150 10076.520.44.3
    San Jose37.049.9104 23484.29.12.8
    Austin33.649.667 46289.114.52.8
    Jacksonville35.851.752 57689.215.93.7
    San Francisco38.348.9104 55288.510.92.6
    Columbus32.251.251 61289.520.43.5
    Indianapolis34.251.946 44285.519.14.0
    • All social determinants of health data were from 2018.

    • *Educational attainment defined as percentage of the population that obtained high school degree or higher.

  • Table 3

    Violent crimes by metropolitan areas (per 100 000)

    YearHomicide, N (per 100 000)Rape, N (per 100 000)Robbery, N (per 100 000)Aggravated assault, N (per 100 000)Total violent crime, N (per 100 000)
    New York2016335 (4.0)2372 (28.1)15 544 (184.1)30 873 (365.6)49 124 (561.8)
    Los Angeles2018258 (3.1)2528 (29.9)10 327 (122.3)17 013 (201.5)30 126 (356.8)
    Chicago2018563 (6.7)1798 (21.3)9684 (114.7)15 312 (181.3)27 357 (324.0)
    Houston2018276 (3.3)1261 (14.9)8761 (103.8)13 764 (163.0)24 062 (285.0)
    Phoenix2018132 (1.6)1086 (12.9)3112 (36.9)7780 (92.1)12 110 (143.4)
    Philadelphia2018351 (4.2)1095 (13.0)5262 (62.3)7712 (91.3)14 420 (170.8)
    San Antonio2018107 (1.3)1346 (15.9)1767 (20.9)6427 (76.1)9647 (114.3)
    San Diego201835 (0.4)605 (7.2)1439 (17.0)3281 (38.9)5360 (63.5)
    Dallas2018155 (1.8)828 (9.8)3987 (47.2)5452 (64.6)10 422 (123.4)
    San Jose201828 (0.3)615 (7.3)1593 (18.9)2208 (26.1)4444 (52.6)
    Austin201832 (0.4)787 (9.3)1021 (12.1)1880 (22.3)3720 (44.1)
    Jacksonville2018110 (1.3)535 (6.3)1323 (15.7)3413 (40.4)5381 (63.7)
    San Francisco201846 (0.5)354 (4.2)3165 (37.5)2579 (30.5)6144 (72.8)
    Columbus201899 (1.2)820 (9.7)1922 (22.8)1575 (18.7)4416 (52.3)
    Indianapolis2018182 (2.2)677 (8.0)3081 (36.5)7250 (85.9)11 170 (132.3)
  • Table 4

    Correlation between social determinants of health, violence and trauma center density

    Level 1 population densityLevel 1 geographic densityHigh-level* population densityHigh-level* geographic density
    RP value†RP value†RP value†RP value†
    Social determinants of health
    Median income0.290.3−0.170.60.420.1−0.230.4
    Education−0.080.80.210.5−0.011.00.080.8
    Poverty rate−0.250.4−0.140.6−0.320.3−0.060.8
    Unemployment rate−0.410.1−0.280.3−0.350.2−0.170.6
    Violence
    Homicide−0.100.7−0.350.2−0.130.6−0.320.3
    Assault0.260.4−0.300.30.140.6−0.280.3
    Total violent crime0.270.3−0.330.30.130.6−0.320.3
    • *High-level signifies level 1 and 2 state designated centers.

    • †P value generated from Pearson correlation test.

Supplementary Materials

  • Figures
  • Tables
  • Additional Files
  • Supplementary data

    [tsaco-2020-000562supp001.pdf]

  • Supplementary data

    [tsaco-2020-000562supp002.pdf]

  • Supplementary data

    [tsaco-2020-000562supp003.pdf]

  • Supplementary data

    [tsaco-2020-000562supp004.pdf]

  • Supplementary data

    [tsaco-2020-000562supp005.pdf]

  • Supplementary data

    [tsaco-2020-000562supp006.pdf]

  • Supplementary data

    [tsaco-2020-000562supp007.pdf]

  • Supplementary data

    [tsaco-2020-000562supp008.pdf]

  • Supplementary data

    [tsaco-2020-000562supp009.pdf]

  • Supplementary data

    [tsaco-2020-000562supp010.pdf]

  • Supplementary data

    [tsaco-2020-000562supp011.pdf]

  • Supplementary data

    [tsaco-2020-000562supp012.pdf]

  • Supplementary data

    [tsaco-2020-000562supp013.pdf]

  • Supplementary data

    [tsaco-2020-000562supp014.pdf]

  • Supplementary data

    [tsaco-2020-000562supp015.pdf]

Additional Files

  • Figures
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  • Supplementary Materials
  • Supplementary Data

    This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

    • Data supplement 1
    • Data supplement 2
    • Data supplement 3
    • Data supplement 4
    • Data supplement 5
    • Data supplement 6
    • Data supplement 7
    • Data supplement 8
    • Data supplement 9
    • Data supplement 10
    • Data supplement 11
    • Data supplement 12
    • Data supplement 13
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Describing the density of high-level trauma centers in the 15 largest US cities
Anne M Stey, Alexandria Byskosh, Caryn Etkin, Robert Mackersie, Deborah M Stein, Karl Y Bilimoria, Marie L Crandall
Trauma Surg Acute Care Open Oct 2020, 5 (1) e000562; DOI: 10.1136/tsaco-2020-000562

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Describing the density of high-level trauma centers in the 15 largest US cities
Anne M Stey, Alexandria Byskosh, Caryn Etkin, Robert Mackersie, Deborah M Stein, Karl Y Bilimoria, Marie L Crandall
Trauma Surg Acute Care Open Oct 2020, 5 (1) e000562; DOI: 10.1136/tsaco-2020-000562
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Describing the density of high-level trauma centers in the 15 largest US cities
Anne M Stey, Alexandria Byskosh, Caryn Etkin, Robert Mackersie, Deborah M Stein, Karl Y Bilimoria, Marie L Crandall
Trauma Surgery & Acute Care Open Oct 2020, 5 (1) e000562; DOI: 10.1136/tsaco-2020-000562
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