Widening Gaps: Racial and Ethnic Disparities in Adolescent Trauma Trends From 2017 to 2022

Purpose: Traumatic injuries are a leading cause of mortality and morbidity among adolescents in the United States, disproportionately impacting racial and ethnic minorities. The COVID-19 pandemic introduced additional socioeconomic and health care challenges. This study assesses trends in adolescent trauma across racial and ethnic groups in the United States from 2017 to 2022, focusing on the pandemic's impact on disparities. Methods: This retrospective cohort study utilized data from the Trauma Quality Programs Participant Use File (2017–2022), including 282,797 adolescents aged 12 to 17 with traumatic injuries. Both fatal and nonfatal injuries were analyzed, stratified by racial/ethnic groups and trauma periods (pre-COVID vs. COVID). Key variables included trauma type, mechanism, intentionality, and Injury Severity Score. Results: During the COVID-19 pandemic, the proportion of Black and Hispanic adolescents among trauma patients increased, whereas the representation of non-Hispanic White adolescents declined. Throughout the study period, Black adolescents consistently exhibited higher mortality rates than other racial and ethnic groups. The mortality rate ratio for Black adolescents compared to their White counterparts was approximately two before the pandemic and approached three following the onset of COVID-19, underscoring a widening disparity. This gap was largely driven by a substantial increase in firearm-related injuries and assaults among adolescents from minority backgrounds—a trend that persisted through 2022. Discussion: The study highlights persistent and worsening racial disparities in adolescent trauma, particularly among Black and Hispanic adolescents. These findings underscore the urgent need for targeted, culturally responsive interventions to reduce firearm-related injuries and address trauma-related disparities.