When someone is shot, stabbed or seriously injured due to a car accident, fall or some other trauma, every minute can make a crucial difference to the patient’s overall outcome, said Connie Potter, president of the Trauma Center Association of America.
“It’s like Gabby Giffords,” Potter said, referring to U.S. Rep. Gabrielle Giffords, D-Arizona, who was critically injured by a gunshot wound to the head during a public event in January. According to news reports, Giffords and six other victims were all transported to a trauma center within 50 minutes of the shooting. Six of the seven survived.
But most adults suffering trauma on Chicago’s South Side can’t get to a trauma center by ambulance as fast as Giffords did. “[If Giffords was shot on the South Side] in Chicago, she’d be in a nursing home if she was alive at all,” Potter said.
That’s because there’s no adult trauma center located in Chicago south of 16th Street. As a result, significant portions of 19 South Side communities are not within 45 minutes of the nearest trauma center by ambulance, according to a Chicago Reporter analysis of a 2010 American Trauma Society map of Illinois trauma centers. The American Trauma Society provides an online interactive map to locate trauma centers across the United States and map the areas within 45 minutes or an hour of those trauma centers by ambulance or helicopter. All of Chicago is within 45 minutes of a trauma center by helicopter, according to the American Trauma Society map of Illinois.
Trauma is the leading cause of death for people under the age of 45, according to the U.S. Centers for Disease Control and Prevention. In Chicago, since 2008, more than 1,560 people have been murdered by some form of trauma—the vast majority by shooting or stabbing—with more than 40 percent of the murders occurring in those 19 South Side communities, according to a Chicago Reporter analysis of city homicide data. They are: Avalon Park, Burnside, Calumet Heights, Chatham, East Side, Englewood, Grand Boulevard, Greater Grand Crossing, Hyde Park, Kenwood, Pullman, Roseland, South Chicago, South Deering, South Shore, Washington Park, West Englewood, West Pullman and Woodlawn.
Potter, whose organization has lobbied Congress to provide more funding to develop more trauma centers, called Chicago’s trauma system “unique” in its lack of coverage when compared to other major cities throughout the country. “Chicago leaving that large of a community without at least a level 2 [trauma center] is unique except for Atlanta,” Potter said.
Trauma centers, unlike most hospital emergency rooms, are specifically equipped to handle severe injuries both in resources, such as equipment, as well as personnel, such as surgeons and specialists, who are required to be available 24 hours a day. A facility’s level designation tells the degree of care it can provide—with levels 1 and 2 being among the highest and level 4 the lowest.
The last adult trauma care center located on the city’s South Side shut down in 1990, at the now-closed Michael Reese Hospital in the Bronzeville neighborhood. Two years earlier, the University of Chicago Medical Center in Hyde Park closed its adult trauma center, citing its high expense to maintain, although its pediatric trauma center remains in operation.
Since that time, victims of trauma on the South Side have been transported to one of five adult trauma centers in and around Chicago; John H. Stroger Hospital and Mount Sinai Medical Center on the city's West Side, Advocate Illinois Masonic Hospital and Northwestern Memorial Hospital on the North Side, or Advocate Christ Medical Center in south suburban Oak Lawn.
The cost of operating level 1 or level 2 facilities is a key reason that less than 10 percent of U.S. hospitals currently provide trauma care. Since the decision to become a trauma center is entirely voluntary, Cook County Health and Hospital Systems CEO Dr. Terry Mason said for many facilities, the issue simply comes down to dollars and cents. “You’ve got to look at the pay rate for the people who come through the door,” Mason said. “If you’ve got people who fall at home, most of the time they’ll have some sort of insurance coverage, in Illinois, everybody has to have some sort of insurance for their automobile, but for the bulk of the people who come in [trauma centers] shot or stabbed there isn’t, and there’s a massive consumption of resources to deal with those types of problems.”
Indeed, trauma care can be a money-losing proposition for many hospitals. The Trauma Center Association of America estimated trauma centers nationwide collectively lost around $230 million a year treating victims who were either uninsured or underinsured. Overall, the total annual expense for trauma care in the U.S. was around $80 billion, according to the association’s estimates.
In spite of the estimates, Potter contended that trauma care could indeed be a money-making proposition for for-profit institutions because of the influx that facility would get of car crash victims, which make more than half of all trauma injuries. “You will get more patients [to a trauma center] with auto insurance that wouldn’t normally come there because you’re a trauma center,” Potter said. “It’s a fallacy that trauma centers do not make money, the only reason they don’t is because they don’t know how.”
Even though all Illinois trauma centers in 2010 received a share of the $3.5 million in funding reserved for trauma care by the Illinois Department of Public Health, Mason said the amount hospitals receive often was not enough to begin to address their costs.
The issue has sparked a number of protests among South Side community groups since last August, when 18-year-old community activist Damian Turner was killed in a drive-by shooting just four blocks away from the U of C Medical Center only to be transported to Northwestern Memorial Hospital, about 10 miles away. The most recent protest was held Monday when demonstrators erected a “tent city” in front of the medical center to mark the one-year anniversary of Turner’s death and demand that the medical center once again provide adult trauma care.
Mason said the county was currently conducting a study of all of southern Cook to determine whether the closure of health care facilities has led to an increase in deaths within that area, which he said included the city’s South Side. “We are looking at it from an academic point of view to find out are there excess deaths as a result of the holes some perceive in the trauma network,” Mason said, adding he anticipated the study’s results to be released within the next couple of months.
Mason said the implementation of any new trauma care facility would be a matter of will on the part of political officials as well as the public, but he added that any conversation about trauma care should also include examining trauma's root cause. “Getting shot or stabbed is 100 percent preventable,” Mason said. “So the question is, we know that they are [getting shot and stabbed], but why are they and are we doing anything about the why.”
--Steven Ross Johnson
Map was created using the American Trauma Society's online interactive map tool.
© Community Renewal Society 2011