Short Communication

Traumatic injury and access to care in rural areas: leveraging linked data and geographic information systems for planning and advocacy


name here
Paula Yuma1
PhD, MPH, Assistant Professor *

name here
Rebecca Orsi2
PhD, Research Scientist

Julie A Dunn3 MD, FACS, Surgeon and Chair of Trauma Research

Victoria Kenyon4 MSW, Research Coordinator

name here
Elizabeth Tulanowski5
MS, Instructor and Coordinator

Lorann Stallones6 MPH, PhD, FACE, Professor, Director


1, 2 School of Social Work and School of Public Health, Colorado State University, Fort Collins, CO, USA

3 Acute Care Surgery, University of Colorado Health, Suite 360, 2500 Rocky Mountain Ave, Loveland, CO, USA

4 Social Work Research Center, Colorado State University, Fort Collins, CO, USA

5 Warner College of Natural Resources and Geospatial Centroid, Colorado State University, Fort Collins, CO, USA

6 Department of Psychology, Injury Control Research Center and School of Public Health, Colorado State University, Fort Collins, CO, USA

ACCEPTED: 4 May 2019

early abstract:

Introduction.The purpose of this ecological study was to apply GIS methods to patterns of traumatic injury and access to trauma care to facilitate system planning and advocacy.

Methods. Four state (Colorado) and national data sources were linked to examine county-level disparities. Average ambulance drive times to trauma centers for populated places in each county were estimated and mapped.

Results. Independent samples t-tests demonstrated Colorado’s rural counties had significantly higher injury hospitalization rates [M=685.4 vs. M=566.3; p=0.005] and fatality rates [M=93.8 vs. M=71.6, p<0.001], indicating residents with the least access to care are the most impacted by the burden of injury; this finding was supported by GIS analyses of drive times to Level I and II trauma centers and underlying injury rates, which are visually displayed.

Conclusions. These methods are useful tools for rural public health professionals to conduct system optimization, identify training and resource needs, assess prevention priorities, and advocate for trauma system support.