Introduction: Studies evaluating traumatic injury shows increased incidence related to rurality, younger ages and social disadvantage. This paper explores the geographic disparities of trauma incidence and injury characteristics of trauma admissions in the Te Manawa Taki Midland (TMT) region of Aotearoa New Zealand.
Methods: A retrospective review of trauma hospitalisation data, collected from the TMT Trauma Registry, was conducted. Patients of all Injury Severity Score ranging 1-75, all ages, admitted to any TMT hospital over 10 years, 2013 to 2022 were included. Rurality was classified based on the recent rurality definitions of Geographic Classification for Health into three categories, Urban, Rural and Remote. Annual incidence per 100,000 population and rate ratios were calculated incorporating annual population adjustments using TMT-Midland Region annual population projections provided by the Ministry of Health.
Results: Rurality is associated with higher risk of non-major trauma admissions (Injury Severity Score <13) injury, but was not with major trauma (Injury Severity Score >12) or injury mortality. Falls were dominant as a cause across all rurality categories followed by road traffic crash which disproportionately affected remote dwellers. Remote dwellers were more likely to sustain injuries from sharps glass/knife/hand tools, while urban dwellers were at higher risk of pedal cycle injuries. Rurality was not significant for ethic variations in trauma admissions.
Conclusion: The health disadvantage of rurality is modulated by the underlying socio-economic, demographic, and environmental conditions. Injury prevention strategies need to focus on these socio-economic, demographic and environment determinants in causation of trauma in Urban, Rural and Remote dwellers.