Racial Disparities in Police Transportation of Trauma Patients Over Time

Abstract

Background: Previous studies observed racial disparities in police transport (PT) of trauma patients, but did not compare injury characteristics or outcomes by race. Examining the association between race, injury characteristics, and outcomes will help elucidate the significance and implications of racial disparities among PTs.

Objective: Describe temporal trends, injuries, and outcomes of PT patients by race.

Materials and methods: This retrospective cohort study included adult trauma patients admitted to six level I-II trauma centers in Colorado, Texas, and Kansas (January 1, 2016-July, 15, 2022). Transfer patients, and other/unknown races were excluded. Comparisons were made by race: non-Hispanic (NH-) White, Black, or Hispanic. The primary outcome was PT, α < 0.05. Among PTs, outcomes included length of stay (LOS) and discharge disposition.

Results: Of 46,581 patients (77% NH-White, 17% Hispanic, 5% Black), there was a significantly higher proportion of PT for Hispanic (0.9%) and Black (0.4%) patients than NH-White (0.1%) patients; p < 0.01. Hispanic PTs experienced falls significantly more than Black or NH-White PTs; p < 0.01. Black PTs suffered assaults more than NH-White or Hispanic PTs; p = 0.03. The proportion of NH-White PT remained relatively stable over time (moderate r² = 0.4). For Black PTs, there was a negative quadratic association over time, peaking in 2019 (moderate r² = 0.3). Conversely, for Hispanic PTs, there was a positive quadratic correlation over time, with a notable drop in PT in 2019, (strong r² = 0.7). There was no difference in hospital LOS between the groups. Hispanic and Black PTs were discharged to jail significantly more (p = 0.001) and home significantly less (p = 0.04) than NH-White PTs (p = 0.01); other discharge dispositions were similar between groups.

Conclusions: Hispanic and Black patients were PTs and subsequently discharged to jail more frequently than NH-White patients. Since 2019 there has been an increase in Hispanic PTs and a decrease in Black PTs.

Keywords: emergency medical services; police transportation; trauma patients.