Living in a minority neighborhood, as well as low education and unemployment, are associated with a high incidence of assault-related orbital fractures, according to a study published in Ophthalmic Plastic Reconstructive Surgery.
Researchers conducted a study to report the demographics of assault-related orbital fractures spanning a 7-year period. They looked at cases treated at a level 1 urban trauma center, and described and analyzed the variation in assault rates across different racial/ethnic neighborhoods for patients residing in Milwaukee County. The study is a retrospective chart review for patients who sustained assault-related orbital fractures from 2013 to 2019.
The research team analyzed a series of binomial regression models evaluating the association of neighborhood racial/ethnic composition, poverty, unemployment, percentage of female heads-of-household, and education level with neighborhood rate of orbital trauma.
Of the 410 adult patients identified who fit the study criteria, 326 (80%) resided in Milwaukee County, 242 (74%) were men, 260 (81%) were single, and 206 (63%) had non-Hispanic Black ethnicity. Compared with rates of orbital trauma from assault in neighborhoods with a majority non-Hispanic White population, incidence rates of orbital injury stemming from assault were higher in neighborhoods where the majority of residents had non-Hispanic Black ethnicity by 5.3 times. They were also higher in neighborhoods where the majority of residents had Hispanic ethnicity (by 3.35 times). For other neighborhoods with a majority of residents with minority ethnicity, rates were higher by 3.94 times.
The researchers explain that factors such as multigenerational poverty and, specifically, differences in socioeconomic status due to racial segregation contribute significantly to these various vulnerabilities among minority populations in Milwaukee County. “This legacy of multigenerational poverty and racial segregation has generated a complex constellation of disadvantage that is difficult to fully account for,” the study authors report.
“The findings demonstrate the compounded burdens minorities face; residents of racial/ethnic minority neighborhoods are disproportionately exposed to not only concentrated poverty and social disadvantages, but also to heightened risk of being a victim of an assault that results in an orbital fracture,” the researchers explain.
Limitations include generalizability of the results due to the hypersegregation of the Milwaukee metro region, and the possibility of some cases not being analyzed due to receiving treatment in other facilities.
Mancera N, Do D, Griepentrog GJ, Esmaili N. Assault-related orbital trauma at an urban level I trauma center: racial segregation and other neighborhood-level social determinants. Ophthalmic Plast Reconstr Surg. Published online October 3, 2022. doi:10.1097/IOP.0000000000002286