LAUSR

Injuries are the leading cause of pediatric mortality, and motor vehicle crashes are the most common cause of injury.1 Efforts to ameliorate morbidity and mortality from these crashes have been focused on both prevention and optimizing care for those who are injured. Although preventive measures in the United States have decreased the number of pediatric deaths, our rate of improvement is lower than that of 19 comparable industrialized nations.2 In addition, although the advent of regional trauma centers has improved outcomes after an injury, the systems of care are not yet leveraged to their full potential and often are not readily accessible to those in rural areas. In this issue of Pediatrics , Mokdad et al3 highlight the disparities in outcomes between children injured in motor vehicle crashes in urban versus rural areas using the Fatality Analysis Reporting System database (years 2010–2017). The authors document higher mortality rates in rural counties and demonstrate lower mortality rates in counties with a regional trauma center. These findings are consistent with decades of literature revealing similar results from the United States and internationally.4–6 It is well known that children … Address correspondence to John Holcroft, MD, Division of Critical Care Medicine, Department of Pediatrics, University of California, Davis, 2556 Stockton Blvd, Sacramento, CA 95827. E-mail: jholcroft{at}ucdavis.edu