Disparities in Access to Trauma Care in Canada: A Geospatial Analysis of Census Data.
Annals of Surgery Open · 2025-10-02 · Observational study
Abstract
OBJECTIVE: To assess the proportion of the Canadian population residing within 1 hour of definitive trauma care at Level 1 and 2 trauma centers, and to examine the sociodemographic characteristics of individuals living beyond this range. BACKGROUND: Disparities in access to trauma care remain a significant challenge in Canada, particularly for individuals in rural and remote communities. These inequities, often influenced by geographic isolation, limited resources, and systemic barriers, adversely impact patient outcomes. METHODS: Geographic Information System methods were employed to define 1-hour ground and air transport catchment areas for adult Level 1 and 2 trauma centers across Canada. The study utilized Statistics Canada Census 2021 data to calculate the population (aged ≥ 15 years) living within and outside the 1-hour distance of these centers. RESULTS: The majority of the adult Canadian population (75.8%; 23,475,747) lives within 1 hour of 32 designated Level 1 and Level 2 trauma centers. Conversely, the population living outside this range (24.2%; 7,503,439) is more likely to be unemployed (12.0% vs 8.0%, P < 0.05), without postsecondary education (21.2% vs 13.6%, P < 0.05), with household incomes of less than 60,000 $/year (10.9% vs 1.7%, P < 0.05), and of Indigenous origin (13.1% vs 3.2%, P < 0.05). With helicopter transport, the population within 1 hour increases to 90.3% (27,981,510); however, socioeconomic disparities persist for populations outside the 1-hour range. CONCLUSIONS: Disparities in access to definitive trauma care persist across Canada, disproportionately affecting lower socioeconomic and Indigenous populations, even with helicopter transport. Targeted efforts are needed to enhance trauma care delivery to these underserved groups.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Helicopter & air ambulance · Equity & disparities · Rural & remote
Related articles
- Geographical and population disparities in timely access to prehospital and advanced level emergency care in New Zealand: a cross-sectional study. (BMJ Open, 2019)
- Poor access to kidney disease management services in susceptible patient populations in rural Australia is associated with increased aeromedical retrievals for acute renal care. (Intern Med J, 2020)
- National Characteristics of Emergency Medical Services in Rural and Frontier Areas: A 2024 Update on Rural-Urban Differences in EMS Care. (Prehosp Emerg Care, 2026)
- Geographical alignment of prehospital critical care services with population need for out-of-hospital cardiac arrest patients. (Scand J Trauma Resusc Emerg Med, 2026)
- Overcoming distance: an exploration of current practices of government and charity-funded critical care transport and retrieval organizations. (Scand J Trauma Resusc Emerg Med, 2023)
- Incidence and Epidemiologic Profile of Time-Sensitive Conditions Requiring Aeromedical Evacuation in the Isolated Areas of Chilean Patagonia. (Wilderness Environ Med, 2026)