We commend Rosen and colleagues1 for addressing the important issue of disparities in outcomes with regard to insurance status. As they note, the many covariants with insurance status make studies like theirs difficult. Although the authors have taken measures to minimize confounding variables, we are concerned that their data do not support the implication that the issue of lack of health insurance, particularly among younger trauma patients, is largely responsible for poorer outcomes within this demographic.
White F, Zwemer F. Disparities in Emergency Trauma Care: Really So “Downwardly”?. Arch Surg. 2010;145(6):603-604. doi:10.1001/archsurg.2010.99