This multicenter, retrospective, cross-sectional study examined the association between neighborhood opportunity (Child Opportunity Index 2.0, COI) and pediatric trauma incidence, mechanism, severity, and disposition among children under 18 in Los Angeles County from 2010 to 2021.
Among 28,034 patients (median age 13.0 years; mortality 1.8%, n=493), lower COI zip codes had higher trauma incidence, with more firearm injuries, assaults/stabbings, and pedestrian/bicyclist strikes. Higher COI areas saw more falls and sports-related injuries (all p<0.001).
Retrospective, cross-sectional design limits causal inference. Zip code–level COI may not reflect individual-level socioeconomic context (ecological fallacy). Single metropolitan area (LA County) limits generalizability.
Children in low-opportunity neighborhoods face higher rates of violent and traffic-related trauma — injury prevention resources and outreach should be prioritized in these areas. Clinicians and public health teams can use COI mapping to target interventions where trauma burden is greatest.
