Among the factors related to survival among individuals with gunshot wounds (GSW) is distance to trauma care. Relatively little is known about neighborhood-level patterns of GSW mortality and distance to hospitals with trauma centers. The current study obtained data on fatal and non-fatal shootings for 9,205 GSW victimization in Detroit, Michigan, between 2011 and 2017. A Bayesian conditional autoregressive model was used to estimate block-group levels of GSW mortality. Clustering techniques were used to identify spatially proximate neighborhoods with higher or lower than expected rates of GSW mortality. Distance to the nearest trauma center was determined to be associated with a 22-percent increase in fatal outcomes, per-mile (OR 1.22, 95 percent CI, 1.06 to 1.40) after adjusting for block-group level covariates. A Getis-Ord Gi* analysis identified 91 block groups with lower than expected rates of GSW mortality and 12 block-groups with higher than expected rates. The study's overall conclusion is that distance to the nearest trauma center was associated with GSW victim survival. Clusters of block-groups with below-average GSW mortality were determined to be near to major trauma centers in Detroit. Thus, improving speed and access to trauma care may reduce the rate of GSW mortality. (publisher abstract modified)
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