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Ethnic differences in injury mortality rates among adult emergency healthcare service users in high-income countries: a scoping review

Gargi Naha Orcid Logo, Fadi Baghdadi, Alan Watkins Orcid Logo, Alison Porter Orcid Logo, Ann John Orcid Logo, Bridie Evans Orcid Logo, Jenna Jones, Julia Williams Orcid Logo, Niroshan Siriwardena Orcid Logo, Ronan Lyons, Sophie Harwood, Steve Goodacre Orcid Logo, Helen Snooks Orcid Logo, Ashra Khanom

Health and Social Care Delivery Research, Pages: 1 - 22

Swansea University Authors: Gargi Naha Orcid Logo, Fadi Baghdadi, Alan Watkins Orcid Logo, Alison Porter Orcid Logo, Ann John Orcid Logo, Bridie Evans Orcid Logo, Jenna Jones, Ronan Lyons, Sophie Harwood, Helen Snooks Orcid Logo, Ashra Khanom

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DOI (Published version): 10.3310/gjak4819

Abstract

Background: Ethnic disparities in healthcare access and outcomes have been widely reported across different settings. In this scoping review, we aimed to explore whether adults from minority racial and ethnic backgrounds face higher risks of death after presenting with injuries to emergency healthca...

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Published in: Health and Social Care Delivery Research
ISSN: 2755-0079
Published: National Institute for Health and Care Research 2026
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URI: https://cronfa.swan.ac.uk/Record/cronfa71522
first_indexed 2026-03-02T22:01:30Z
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In this scoping review, we aimed to explore whether adults from minority racial and ethnic backgrounds face higher risks of death after presenting with injuries to emergency healthcare services in high-income countries. Methods: We searched five electronic databases [Cumulative Index to Nursing and Allied Health Literature, MEDLINE, Cochrane, Scopus and PsycInfo&#xAE; (American Psychological Association, Washington, DC, USA)] for peer-reviewed studies published between January 2010 and March 2024. We included studies that compared mortality outcomes by race or ethnicity in emergency healthcare settings such as ambulance services, trauma centres and hospital emergency departments in high-income countries. Results: Out of the 1873 articles identified, 32 met the inclusion criteria. Of these, 20 reported higher risk of mortality for ethnic minority patients compared to White patients following injury. Most studies were conducted in the USA with limited representation from other high-income countries such as Canada and Israel. This strong emphasis on USA-based research limits how well the findings apply to other countries with different healthcare systems. A major issue identified across the studies was the inconsistency in how race and ethnicity were recorded and reported. This lack of standardisation makes it difficult to compare results across studies and may hide the true extent of disparities. Future work: To better understand and address ethnic disparities in trauma care, future research should adopt consistent and inclusive ethnicity coding to improve data quality and comparability across studies. Studies should be conducted in a wider range of high-income countries and include pre-hospital settings, where disparities may first appear. This will help build a more globally relevant evidence base. Researchers should also take an intersectional approach, examining how ethnicity combines with other social determinants to influence outcomes. In addition to mortality, future studies using longitudinal and mixed-methods designs should explore long-term recovery and access to rehabilitation to gauge the full impact of these health disparities. Limitations: The review focused solely on mortality outcomes, limiting insight into broader health outcomes such as long-term recovery, quality of life or patient experiences. It also did not explore how ethnicity interacts with other social factors such as gender, income, disability or immigration status. These gaps obscure the full extent of inequalities in emergency care. Conclusion: This review adds to the growing evidence that ethnic minority patients in high-income countries could be at a higher risk of injury-related deaths. However, inconsistent ethnicity coding and a USA-centric evidence base limit the generalisability of findings. To create fairer and more effective emergency care systems, future research must improve data quality, broaden its geographic scope and consider the complex social factors that shape health outcomes.</abstract><type>Journal Article</type><journal>Health and Social Care Delivery Research</journal><volume>0</volume><journalNumber/><paginationStart>1</paginationStart><paginationEnd>22</paginationEnd><publisher>National Institute for Health and Care Research</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>2755-0079</issnElectronic><keywords/><publishedDay>1</publishedDay><publishedMonth>2</publishedMonth><publishedYear>2026</publishedYear><publishedDate>2026-02-01</publishedDate><doi>10.3310/gjak4819</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>Other</apcterm><funders>National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR132744.</funders><projectreference/><lastEdited>2026-04-09T14:47:39.6640637</lastEdited><Created>2026-03-02T16:26:43.6232854</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Gargi</firstname><surname>Naha</surname><orcid>0000-0003-4293-5894</orcid><order>1</order></author><author><firstname>Fadi</firstname><surname>Baghdadi</surname><order>2</order></author><author><firstname>Alan</firstname><surname>Watkins</surname><orcid>0000-0003-3804-1943</orcid><order>3</order></author><author><firstname>Alison</firstname><surname>Porter</surname><orcid>0000-0002-3408-7007</orcid><order>4</order></author><author><firstname>Ann</firstname><surname>John</surname><orcid>0000-0002-5657-6995</orcid><order>5</order></author><author><firstname>Bridie</firstname><surname>Evans</surname><orcid>0000-0003-0293-0888</orcid><order>6</order></author><author><firstname>Jenna</firstname><surname>Jones</surname><orcid/><order>7</order></author><author><firstname>Julia</firstname><surname>Williams</surname><orcid>0000-0003-0796-5465</orcid><order>8</order></author><author><firstname>Niroshan</firstname><surname>Siriwardena</surname><orcid>0000-0003-2484-8201</orcid><order>9</order></author><author><firstname>Ronan</firstname><surname>Lyons</surname><order>10</order></author><author><firstname>Sophie</firstname><surname>Harwood</surname><order>11</order></author><author><firstname>Steve</firstname><surname>Goodacre</surname><orcid>0000-0003-0803-8444</orcid><order>12</order></author><author><firstname>Helen</firstname><surname>Snooks</surname><orcid>0000-0003-0173-8843</orcid><order>13</order></author><author><firstname>Ashra</firstname><surname>Khanom</surname><order>14</order></author></authors><documents><document><filename>71522__36480__2488b0ad5e3241ac83bbf043cbe13d65.pdf</filename><originalFilename>71522.VoR.pdf</originalFilename><uploaded>2026-04-09T14:36:21.9390301</uploaded><type>Output</type><contentLength>1245122</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; 2026 Naha et al. 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spelling 2026-04-09T14:47:39.6640637 v2 71522 2026-03-02 Ethnic differences in injury mortality rates among adult emergency healthcare service users in high-income countries: a scoping review 3da7223a6ff1f9179f187a63187b5fbd 0000-0003-4293-5894 Gargi Naha Gargi Naha true false eba9bb478b589955aa9e749a0f0e7186 Fadi Baghdadi Fadi Baghdadi true false 81fc05c9333d9df41b041157437bcc2f 0000-0003-3804-1943 Alan Watkins Alan Watkins true false fcc861ec479a79f7fb9befb13192238b 0000-0002-3408-7007 Alison Porter Alison Porter true false ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 6098eddc58e31ac2f3e070cb839faa6a 0000-0003-0293-0888 Bridie Evans Bridie Evans true false e662b6c5aba239a9cd0f115d16df0a82 Jenna Jones Jenna Jones true false 83efcf2a9dfcf8b55586999d3d152ac6 Ronan Lyons Ronan Lyons true false 7e3308eb12b91f64766b449c6fd9f4d8 Sophie Harwood Sophie Harwood true false ab23c5e0111b88427a155a1f495861d9 0000-0003-0173-8843 Helen Snooks Helen Snooks true false 1f0f14742e3a36e8fd6d29f59374a009 Ashra Khanom Ashra Khanom true false 2026-03-02 MEDS Background: Ethnic disparities in healthcare access and outcomes have been widely reported across different settings. In this scoping review, we aimed to explore whether adults from minority racial and ethnic backgrounds face higher risks of death after presenting with injuries to emergency healthcare services in high-income countries. Methods: We searched five electronic databases [Cumulative Index to Nursing and Allied Health Literature, MEDLINE, Cochrane, Scopus and PsycInfo® (American Psychological Association, Washington, DC, USA)] for peer-reviewed studies published between January 2010 and March 2024. We included studies that compared mortality outcomes by race or ethnicity in emergency healthcare settings such as ambulance services, trauma centres and hospital emergency departments in high-income countries. Results: Out of the 1873 articles identified, 32 met the inclusion criteria. Of these, 20 reported higher risk of mortality for ethnic minority patients compared to White patients following injury. Most studies were conducted in the USA with limited representation from other high-income countries such as Canada and Israel. This strong emphasis on USA-based research limits how well the findings apply to other countries with different healthcare systems. A major issue identified across the studies was the inconsistency in how race and ethnicity were recorded and reported. This lack of standardisation makes it difficult to compare results across studies and may hide the true extent of disparities. Future work: To better understand and address ethnic disparities in trauma care, future research should adopt consistent and inclusive ethnicity coding to improve data quality and comparability across studies. Studies should be conducted in a wider range of high-income countries and include pre-hospital settings, where disparities may first appear. This will help build a more globally relevant evidence base. Researchers should also take an intersectional approach, examining how ethnicity combines with other social determinants to influence outcomes. In addition to mortality, future studies using longitudinal and mixed-methods designs should explore long-term recovery and access to rehabilitation to gauge the full impact of these health disparities. Limitations: The review focused solely on mortality outcomes, limiting insight into broader health outcomes such as long-term recovery, quality of life or patient experiences. It also did not explore how ethnicity interacts with other social factors such as gender, income, disability or immigration status. These gaps obscure the full extent of inequalities in emergency care. Conclusion: This review adds to the growing evidence that ethnic minority patients in high-income countries could be at a higher risk of injury-related deaths. However, inconsistent ethnicity coding and a USA-centric evidence base limit the generalisability of findings. To create fairer and more effective emergency care systems, future research must improve data quality, broaden its geographic scope and consider the complex social factors that shape health outcomes. Journal Article Health and Social Care Delivery Research 0 1 22 National Institute for Health and Care Research 2755-0079 1 2 2026 2026-02-01 10.3310/gjak4819 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Other National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR132744. 2026-04-09T14:47:39.6640637 2026-03-02T16:26:43.6232854 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Gargi Naha 0000-0003-4293-5894 1 Fadi Baghdadi 2 Alan Watkins 0000-0003-3804-1943 3 Alison Porter 0000-0002-3408-7007 4 Ann John 0000-0002-5657-6995 5 Bridie Evans 0000-0003-0293-0888 6 Jenna Jones 7 Julia Williams 0000-0003-0796-5465 8 Niroshan Siriwardena 0000-0003-2484-8201 9 Ronan Lyons 10 Sophie Harwood 11 Steve Goodacre 0000-0003-0803-8444 12 Helen Snooks 0000-0003-0173-8843 13 Ashra Khanom 14 71522__36480__2488b0ad5e3241ac83bbf043cbe13d65.pdf 71522.VoR.pdf 2026-04-09T14:36:21.9390301 Output 1245122 application/pdf Version of Record true © 2026 Naha et al. This is an Open Access publication distributed under the terms of the Creative Commons Attribution CC BY 4.0 licence. true eng https://creativecommons.org/licenses/by/4.0/
title Ethnic differences in injury mortality rates among adult emergency healthcare service users in high-income countries: a scoping review
spellingShingle Ethnic differences in injury mortality rates among adult emergency healthcare service users in high-income countries: a scoping review
Gargi Naha
Fadi Baghdadi
Alan Watkins
Alison Porter
Ann John
Bridie Evans
Jenna Jones
Ronan Lyons
Sophie Harwood
Helen Snooks
Ashra Khanom
title_short Ethnic differences in injury mortality rates among adult emergency healthcare service users in high-income countries: a scoping review
title_full Ethnic differences in injury mortality rates among adult emergency healthcare service users in high-income countries: a scoping review
title_fullStr Ethnic differences in injury mortality rates among adult emergency healthcare service users in high-income countries: a scoping review
title_full_unstemmed Ethnic differences in injury mortality rates among adult emergency healthcare service users in high-income countries: a scoping review
title_sort Ethnic differences in injury mortality rates among adult emergency healthcare service users in high-income countries: a scoping review
author_id_str_mv 3da7223a6ff1f9179f187a63187b5fbd
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author_id_fullname_str_mv 3da7223a6ff1f9179f187a63187b5fbd_***_Gargi Naha
eba9bb478b589955aa9e749a0f0e7186_***_Fadi Baghdadi
81fc05c9333d9df41b041157437bcc2f_***_Alan Watkins
fcc861ec479a79f7fb9befb13192238b_***_Alison Porter
ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John
6098eddc58e31ac2f3e070cb839faa6a_***_Bridie Evans
e662b6c5aba239a9cd0f115d16df0a82_***_Jenna Jones
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons
7e3308eb12b91f64766b449c6fd9f4d8_***_Sophie Harwood
ab23c5e0111b88427a155a1f495861d9_***_Helen Snooks
1f0f14742e3a36e8fd6d29f59374a009_***_Ashra Khanom
author Gargi Naha
Fadi Baghdadi
Alan Watkins
Alison Porter
Ann John
Bridie Evans
Jenna Jones
Ronan Lyons
Sophie Harwood
Helen Snooks
Ashra Khanom
author2 Gargi Naha
Fadi Baghdadi
Alan Watkins
Alison Porter
Ann John
Bridie Evans
Jenna Jones
Julia Williams
Niroshan Siriwardena
Ronan Lyons
Sophie Harwood
Steve Goodacre
Helen Snooks
Ashra Khanom
format Journal article
container_title Health and Social Care Delivery Research
container_volume 0
container_start_page 1
publishDate 2026
institution Swansea University
issn 2755-0079
doi_str_mv 10.3310/gjak4819
publisher National Institute for Health and Care Research
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
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description Background: Ethnic disparities in healthcare access and outcomes have been widely reported across different settings. In this scoping review, we aimed to explore whether adults from minority racial and ethnic backgrounds face higher risks of death after presenting with injuries to emergency healthcare services in high-income countries. Methods: We searched five electronic databases [Cumulative Index to Nursing and Allied Health Literature, MEDLINE, Cochrane, Scopus and PsycInfo® (American Psychological Association, Washington, DC, USA)] for peer-reviewed studies published between January 2010 and March 2024. We included studies that compared mortality outcomes by race or ethnicity in emergency healthcare settings such as ambulance services, trauma centres and hospital emergency departments in high-income countries. Results: Out of the 1873 articles identified, 32 met the inclusion criteria. Of these, 20 reported higher risk of mortality for ethnic minority patients compared to White patients following injury. Most studies were conducted in the USA with limited representation from other high-income countries such as Canada and Israel. This strong emphasis on USA-based research limits how well the findings apply to other countries with different healthcare systems. A major issue identified across the studies was the inconsistency in how race and ethnicity were recorded and reported. This lack of standardisation makes it difficult to compare results across studies and may hide the true extent of disparities. Future work: To better understand and address ethnic disparities in trauma care, future research should adopt consistent and inclusive ethnicity coding to improve data quality and comparability across studies. Studies should be conducted in a wider range of high-income countries and include pre-hospital settings, where disparities may first appear. This will help build a more globally relevant evidence base. Researchers should also take an intersectional approach, examining how ethnicity combines with other social determinants to influence outcomes. In addition to mortality, future studies using longitudinal and mixed-methods designs should explore long-term recovery and access to rehabilitation to gauge the full impact of these health disparities. Limitations: The review focused solely on mortality outcomes, limiting insight into broader health outcomes such as long-term recovery, quality of life or patient experiences. It also did not explore how ethnicity interacts with other social factors such as gender, income, disability or immigration status. These gaps obscure the full extent of inequalities in emergency care. Conclusion: This review adds to the growing evidence that ethnic minority patients in high-income countries could be at a higher risk of injury-related deaths. However, inconsistent ethnicity coding and a USA-centric evidence base limit the generalisability of findings. To create fairer and more effective emergency care systems, future research must improve data quality, broaden its geographic scope and consider the complex social factors that shape health outcomes.
published_date 2026-02-01T05:51:45Z
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score 11.101457

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