Minorities and Uninsured More Likely to Die when Car Meets Pedestrian, Study Says

September 6, 2010

The Insurance Journal is reporting something interesting from the world of health insurance: a new study conducted by researchers at Johns Hopkins has found that when pedestrians get hit by cars, uninsured minority victims are significantly more likely to die as a result than insured white victims with similar injuries. In addition, pedestrians who belong to ethnic minorities are more likely to get hit by cars in the first place.

According to the senior author of the study, Adil H. Haider, M.D., M.P.H., an assistant professor of surgery at the Johns Hopkins University School of Medicine, “It’s a double whammy. Minorities are much more likely to get injured by this mechanism and much more likely to die by this mechanism.”

Haider, along with Rubie Sue Maybury, M.D., M.P.H., reviewed information on over 26,000 patients who were hit by motor vehicles between 2002 and 2006. The research, which was provided by the National Trauma Data Bank, showed that African-American patients had a 22% greater risk of death, and Hispanic patients had a 33% greater risk than white patients who were involved in similar accidents. In addition, those patients who are uninsured had a risk of death that was 77% greater than that of those with insurance, even if they received treatments in hospital emergency rooms, which have long been assumed to be the health care industry’s great equalizer.

Haider, who also holds the position of co-director of the Johns Hopkins Center for Surgical Trials and Outcomes Research, reiterated that the greater death risks for minorities and the uninsured are not accounted for by increased rates of injury. “Do we treat minorities and the uninsured differently? I don’t think so, but we’ve got to ask the question. We don’t actually know what is leading to these disparities.”

Other studies have shown that both ethnicity and insurance status may increase the risk of mortality because of differences in available services, or delay in treatment. As well, a greater prevalence of (or lack of treatment for) common comorbidities such as diabetes, hypertension, or obesity, may be factors that increase the risk of death among injured crash victims who are uninsured or belong to ethnic minorities.

Haider pointed out that since underlying causes for these risk disparities can’t be easily addressed, policymakers need to focus on accident prevention programs for pedestrians, especially in inner cities, where a significant number of these deadly crashes happen. He held up the great success with regard to the use of seat belts and safety seats for children as innovations that have saved lives, and said that pedestrian education could also help, though, he conceded, the problem of injury to pedestrians may be more complicated.

Other Johns Hopkins researchers who worked on this study are Cassandra Villegas; Elliott R. Haut, M.D.; Kent Stevens, M.D., M.P.H.; and David T. Efron, M.D.