Prevalence and ethnic/racial disparities in the distribution of pediatric injuries in South Florida: implications for the development of community prevention programs.

BACKGROUND: The state of Florida continues to report significant gender, ethnic and racial disparities in trauma incidence, access to care and outcomes in the adult population. Our objective was to assess pediatric injury profiles and ethnic/racial disparities of specific injuries in a Regional Trauma Center (TC) in South Florida. METHODS: Retrospective data from November 2011 to December 2015 were obtained from the Level 2 TC registry for children ≤21 years old. Demographic, injury pattern, geographic area, injury scores and treatment data were analyzed. RESULTS: One thousand six hundred ten patients, ages 0-21 years were cared for at the TC from 2011 to 2015.73% were males. Mean age = 15.7 years. Mortality was 2.3%. Using zip code data and using geographic mapping, we identified two main clusters where injuries were occurring. A multinomial regression analysis demonstrated that Hispanics had higher risks of falls (RR 10.4, 95% CI 2.7-29), motorcycle accidents (RR 3.7, 95% CI 1.7-8.2) and motor vehicle accidents (RR 6.4, 95% CI 3.6-11.4). Black/African American children had higher risks of gunshot wounds and resultant mortality (p < 0.01). CONCLUSION: There were racial, ethnic and gender disparities in the patterns of injury and outcomes among the youth attended at our TC. Geographic mapping allowed us the identification of the zones in South Florida where injuries were occurring. Understanding the differences and using geographic mapping to identify regions of higher prevalence will complement planning for prevention programs.

Health literacy and asthma management among African-American adults: an interpretative phenomenological analysis.

OBJECTIVE: African-Americans share a disproportionate burden of asthma and low health literacy and have higher asthma morbidity and mortality. Factors that link the relationship between health literacy and health outcomes are unclear. This study aimed to use patients' experiences of managing asthma to better understand the relationship between health literacy and health outcomes. METHODS: This study was the qualitative component of a mixed methods study. Following quantitative data collection, four participants, two with low print-related health literacy and two with adequate print-related health literacy, completed semi-structured interviews. Interview data were analyzed using interpretative phenomenological analysis. RESULTS: Three themes emerged from the analysis: information desired versus information received, trial and error, and expectations of the patient-provider relationship. Individuals with adequate print-related health literacy had different strategies for overcoming barriers related to communicating with their providers, learning about their disease and experiences of discrimination within the healthcare system. CONCLUSIONS: Individuals with adequate print-related health literacy may be more equipped to participate in shared decision making and feel more confident to successfully manage their disease. It is also important that health literacy is discussed in the context of the cultural and racial background of the population of interest. This interdependent relationship between health literacy and culture is particularly important for African-Americans.