Cook Alan, Harris Robin, Brown Heidi E, Bedrick Edward
Department of Epidemiology and Biostatistics, University of Texas Health Science Center Tyler School of Community and Rural Health, 11937 U.S. Highway 271, H252, Tyler, TX, 75708, USA.
Department of Epidemiology and Biostatistics, University of Arizona Mel and Enid Zuckerman College of Public Health, 1295 N. Martin Ave., Drachman Hall, Tucson, AZ, 85724, USA.
Inj Epidemiol. 2020 Jun 15;7(1):34. doi: 10.1186/s40621-020-00258-x.
Injury-causing events are not randomly distributed across a landscape, but how they are associated with the features and characteristics of the places where they occur in Arizona (AZ) remains understudied. Clustering of trauma events and associations with areal sociodemographic characteristics in the greater Phoenix (PHX), AZ region can promote understanding and inform efforts to ameliorate a leading cause of death and disability for Arizonans. The outcomes of interest are trauma events unrelated to motor vehicle crashes (MVC) and the subgroup of trauma events due to interpersonal assaults.
A retrospective, ecological study was performed incorporating data from state and national sources for the years 2013-2017. Geographically weighted regression models explored associations between the rates of non-MVC trauma events (n/10,000 population) and the subgroup of assaultive trauma events per 1000 and areal characteristics of socioeconomic deprivation (areal deprivation index [ADI]), the density of retail alcohol outlets for offsite consumption, while controlling for race/ethnicity, population density, and the percentage urban population.
The 63,451 non-MVC traumas within a 3761 mile study area encompassing PHX and 22 surrounding communities, an area with nearly 60% of the state's population and 54% of the trauma events in the AZ State Trauma Registry for the years 2013-2017. Adjusting for confounders, ADI was associated with the rates of non-MVC and assaultive traumas in all census block groups studied (mean coefficients 0.05 sd. 0.001 and 0.07 sd. 0.002 for non-MVC and assaultive trauma, respectively). Alcohol retail outlet density was also associated with non-MVC and assaultive traumas in fewer block groups compared to ADI.
Socioeconomic deprivation and alcohol outlet density were associated with injury producing events in the greater PHX area. These features persist in the environment before and after the traumas occur. Ongoing research is warranted to identify the most influential areal predictors of traumatic injury-causing events in the greater PHX area to inform and geographically target prevention initiatives.
导致受伤的事件并非在整个区域随机分布，但它们与亚利桑那州（AZ）发生地点的特征和特点之间的关联仍未得到充分研究。亚利桑那州大凤凰城（PHX）地区创伤事件的聚集以及与区域社会人口学特征的关联，有助于促进对这一亚利桑那州人死亡和残疾主要原因的理解，并为改善措施提供依据。感兴趣的结果是与机动车碰撞（MVC）无关的创伤事件以及人际攻击导致的创伤事件亚组。
进行了一项回顾性生态研究，纳入了2013 - 2017年来自州和国家来源的数据。地理加权回归模型探讨了非MVC创伤事件发生率（每10,000人口中的事件数）与每1000例攻击创伤事件亚组以及社会经济剥夺的区域特征（区域剥夺指数[ADI]）、场外消费的零售酒精销售点密度之间的关联，同时控制种族/民族、人口密度和城市人口百分比。
在一个涵盖PHX和22个周边社区的3761英里研究区域内，有63,451起非MVC创伤事件，该区域人口占该州近60%，且在2013 - 2017年的亚利桑那州创伤登记中占创伤事件的54%。在对混杂因素进行调整后，ADI与所有研究的普查街区组中的非MVC和攻击创伤发生率相关（非MVC和攻击创伤的平均系数分别为0.05±0.001和0.07±0.002）。与ADI相比，酒精零售销售点密度与较少街区组中的非MVC和攻击创伤也相关。
社会经济剥夺和酒精销售点密度与大PHX地区的致伤事件相关。这些特征在创伤发生前后的环境中持续存在。有必要进行持续研究，以确定大PHX地区创伤致伤事件最具影响力的区域预测因素，为预防举措提供信息并进行地理定位。
