Disparities, Health Inequities, and Vulnerable Populations: Will Academic Medicine Meet the Challenge?

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Several years ago, I was caring for Thomas Chee (name changed), a Native American man, who had been transferred from another hospital after he was hit by a car while crossing the street. The part of New Mexico where the injury occurred is an area known to be a high-risk one for Native American pedestrians. Gallaher et al1 have suggested that the high death rate for Native American pedestrians in New Mexico is due to off-reservation drinking at night that leaves individuals with limited options to “hitch rides back to the reservation on unlit roads with intoxicated drivers” or causes some to attempt to wait until morning “at the mercy of winter in New Mexico, when nighttime temperatures often drop below minus 12 degrees Centigrade.” Gallaher et al noted that compared with other New Mexicans, “Native Americans were nearly eight times more likely to die in pedestrian motor vehicle crashes and 30 times more likely to die of hypothermia.
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