Study shows Asian and African-American patients more likely to die after injury

Effect of race on post-injury care examined

A study using data from Hawai'i and 21 other states finds Asian and African-American patients have a higher risk of dying than Caucasians do after they are injured and admitted to hospitals.

The results are reported in "Racial Disparities in Mortality Among Adults Hospitalized After Injury," co-written by newly-appointed Dean of the John A. Burns School of Medicine, Jerris Hedges, MD. It appears in the February 2008 issue of Medical Care, a national journal.

The majority of the patients suffered injuries to their head, legs, chest, spleen, or liver. Caucasian patients were likely to die in the hospital following a significant injury at a rate of 1.5%. Asians (including Pacific Islanders) and African-Americans died at the higher rates, of 2.0% and 2.1%, respectively.

"The poorer survival outcome for Asian and Pacific Island and African-American patients is concerning," said Dr. Hedges. "I hope that in Hawai'i, we can re-visit the status of trauma care and strengthen the efforts to save the lives of those with major injury through a systems approach to trauma care delivery."

Dr. Hedges notes that the John A. Burns School of Medicine is a natural venue for such continued study. Last December, the medical school announced the establishment of a new Center for Native and Pacific Health Disparities Research within the Department of Native Hawaiian Health. The Center's Co-Director, Dr. Marjorie Mau, agrees that injury disparities are an under-studied field. "It will be important to conduct future studies to understand why there are racial/ethnic differences in health outcomes following injury," said Dr. Mau. The health disparities research center is currently studying outcome differences in diabetes, kidney disease, cardio metabolic syndrome and obesity.

Dr. Danny Takanishi, Chair of the Department of Surgery, said the disparities research center will promote multi-disciplinary collaboration. "The Department of Native Hawaiian Health and the Department of Surgery look forward to collaborating with other community groups to further study the epidemiology of traumatic injuries in Hawai'i and to work towards the development of a mature trauma system, including transport and triage issues, injury prevention, and outreach," said Dr. Takanishi.

Dr. Hedges, co-author of the injuries study in Medical Care, is an Emergency Medicine specialist who has written several books, including the popular textbook "Clinical Procedures in Emergency Medicine." A vigorous researcher, he has authored or contributed to hundreds of articles published in medical journals.

Hedges' tenure as Dean of the John A. Burns School of Medicine begins in March. He has been Vice Dean of the Oregon Health and Science University School of Medicine in Portland, Oregon since April 2005.

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