If you’re ever faced with a life-threatening injury in Chicago, you might not know that paramedics have to decide the best kind of hospital to send you to. That’s because some emergency rooms offer more intense care than others. The ones called Level I trauma centers handle the most severe injuries. Chicago is served by six adult Level I trauma centers, four of which lie within the city. They are not spread around equally, and some Chicagoans claim this trauma center layout leaves their neighborhoods vulnerable.
WBEZ took a close look at those claims in a three-part series, the first of which profiles critics who are clamoring for the South Side to have its own facility.
So, what exactly is an adult, Level I trauma center?
POTTER: First of all, trauma centers have to have 24-hour-a-day readiness, whether they have a patient or not.
Nurse Connie Potter is president of the National Foundation for Trauma Care, a kind of trauma trade group. Potter says trauma centers are not regular hospital emergency rooms. They have many more players, most with specialized training.
POTTER: They have to have surgeons, neurosurgeons, orthopedists, plastic surgeons, ear nose and throat, urologists, opthamologists.
Potter says this level of up-to-the minute care is pricey. Research shows that the average lifetime patient cost at a trauma care center is 30,000 dollars more than at a nontrauma center. And, it so happens that the centers tend to serve poor, minority communities. Potter says cities like Atlanta, Washington, D.C., and Los Angeles, all grapple with financing trauma centers.
There are Chicagoans who wonder if trauma care is fair and equal here, too. Right now, none of Chicago’s four adult trauma centers is on the South Side.
That bothers U.S. Congressman Bobby Rush, who serves a South Side district. For Rush, the issue became personal in 1999.
RUSH: My awareness became much more intense when my son was killed right across the street from a hospital.
Rush’s son had been shot, and that nearby hospital did not have a trauma center to treat his serious wounds. Instead, Rush’s son had to travel from 79th Street to a center at Christ Hospital in south suburban Oak Lawn. The congressman says he feels things could have been different for his son, if the South Side had had its own trauma center.
RUSH: He might still be alive today.
Once upon a time, the South Side had several adult trauma centers. Michael Reese and the University of Chicago hospitals each had one.
RUSH: When you take the whole issue of access to health care in poor, minority and black communities, then it’s always not a high priority. It’s always it’s too expensive. I just have to say if there weren’t a Level I trauma center in a middle-class white communities, there’d be all kind of outcries.
Congressman Rush is not the only advocate of bringing a trauma center to the South Side. In fact, WBEZ decided to look at the issue closely because some South Side youth organized around the issue.
ACTIVISTS (chanting): Damian, this is all for you. We will get a trauma center for you.
Damian Turner was a youth activist who was killed by a stray bullet in 2010. He was hit while he was on the South Side, near the University of Chicago. But he was transported downtown to an adult trauma center at Northwestern University.
A group called Fearless Leading by the Youth believes if the university had it’s own trauma center, Damian Turner would have gotten treatment sooner and lived.
ACTIVISTS (chanting): What do we want? Trauma centers! When do we want it? Now!
Protesters continue to clamor for the hospital to reinstate its adult trauma center. The university has said that’s not going to happen and touts its trauma center for children as well as other health initiatives. The youth activists say they are inspired by Damian Turner, and their persistence is unwavering.
Kandice Denard is Turner’s sister.
DENARD: We want a trauma center out of it. We want what’s best for this community. Because at the end of the day, the people is the most important thing. The community is what’s important. We don’t want to fight. We don’t want to rebel. We want to actually partnership and get a trauma center and get what’s best for our community.
Turner’s mother is Sheila Rush — no relation to Congressman Rush. She recalls a conversation she had prior to her son Damian’s death.
RUSH: The year before the injury happened to Damian, he had a friend named Tommy. Tommy was also murdered the same way, on the same streets. Did the same way. They took him to Northwestern hospital and it really affected him. Because that was his best friend. He was telling me ‘I wish I could do something about that' because if they had a trauma center down there, they probably could’ve saved his life, too. At the time he was telling me that, but the following year the same thing happened to him.
Politicians and activists aren’t the only people concerned that there’s no adult trauma center on the South Side: Some health professionals are worried, too. Dennis Kosuth is with the local branch of the National Nurses Union.
KOSUTH: You see the trauma situation as part of a wider problem of inequality when it comes to health care and this is an issue we feel very strongly about. You have this health care reform, which has passed in 2010. But even with that, you’re going to see massive disparities in health care.
WBEZ has heard clear cries for someone to step in and address the lack of adult trauma care on the South Side. But we haven’t heard clear indications of whether there’s a real need.
The arguments we hear are pretty straightforward: If South Side patients could get to a South Side trauma center, ambulances would move faster, and that would save lives.
So, we grabbed hold of data about how quickly ambulances pick up patients and drop them off at Level I trauma centers in the city and suburbs. Our analysis suggests the slowest trauma-related ambulance runs begin in Chicago ZIP codes that roughly correspond to the South Side neighborhoods of Woodlawn, Hyde Park, South Shore, Pullman and the far Southeast Side. The fastest run times are downtown or very close to the North Side.
In coming installments of this series, we take a closer look at these findings and how the current dispersion of trauma care got this way. Later, we look at whether the situation is putting lives at risk.
WBEZ analyzed data regarding trauma-related ambulance runs. For these purposes, an ambulance run is defined as an ambulance's trip between departure from an emergency scene to the placement of a patient at a Level I trauma center. Run times are reported in minutes. The analysis included data provided by the Illinois Department of Public Health. The reporting period was between January 2008 and December 2010. Geographic data included in the analysis are limited to Chicago ZIP codes. Per suggestions from health professionals, WBEZ eliminated records that included obvious errors, such as run times that lay outside the realm of possibility, e.g., run times that were listed as being months-long.
Citing federal health privacy regulations, IDPH did not grant WBEZ’s request for more finely-honed geographic data. A similar request to Chicago’s Office of Emergency Management and Communications returned records over a similar reporting period, but the data were not useful in our analysis; like IDPH, OEMC cited federal regulations, but the Chicago agency did not provide geographically specific data, including ZIP codes.
Darker areas denote slower ambulance travel times between emergency scenes and patient drop-offs at Level I trauma centers. Lighter areas denote faster run times. Clicking on a ZIP code reveals the median run time within that part of the city.
Proportion of ambulance runs lasting 20 minutes or more
Darker areas denote higher proportions of trauma-related ambulance runs that took 20 minutes or more. A run time of twenty minutes or less is considered a professional standard within Chicago. Clicking on a ZIP code reveals the percentage and number of trauma-related ambulance runs that lasted 20 minutes or more.
Proportion of ambulance runs lasting 30 minutes or more
Darker areas denote higher proportions of trauma-related ambulance runs that took 30 minutes or more. A run time of twenty minutes or less is considered a professional standard within Chicago. Clicking on a ZIP code reveals the percentage and number of trauma-related ambulance runs that lasted 30 minutes or more.
Count of trauma-related ambulance runs
Darker areas denote higher numbers of trauma-related ambulance runs. Clicking on a ZIP code reveals the number of runs within that part of the city.
Chicago’s trauma network comprises six adult facilities (depicted in red), four within the city and another two in the suburbs: Advocate Lutheran General in Park Ridge and Advocate Christ in Oak Lawn. Level I trauma centers outside the network accept Chicago patients under certain circumstances.
View Chicago Area Level I Trauma Centers in a larger map