# Access to pediatric extracorporeal membrane oxygenation: a geospatial analysis of the racial/ethnic composition of areas with and without access

## TL;DR

This study examines how access to pediatric ECMO varies by race and ethnicity, finding that American Indian and Hispanic populations are less likely to live near ECMO centers.

## Contribution

The study introduces a geospatial analysis linking race/ethnicity to access to pediatric ECMO, highlighting disparities in proximity.

## Key findings

- 43% of the US land area lacks access to pediatric ECMO centers.
- American Indian/Native Americans and Hispanic/Latina(o)s are disproportionately without access to ECMO by proximity.
- Distance is identified as an actionable factor in improving access for historically excluded populations.

## Abstract

We propose that all communities should have access to lifesaving technologies like pediatric extracorporeal membrane oxygenation (ECMO), and that distance is one actionable component to accessibility. We chose to examine whether geographic access by distance to pediatric ECMO differs by race/ethnicity for populations historically excluded from health services and technologies.

Population data was obtained from the US Census Bureau’s American Community Survey. Pediatric ECMO program data was obtained from the Extracorporeal Life Support Organization Registry. We compared the proportion of individuals that are American Indian/Alaska Native, Black/African American, Hispanic/Latina(o), or White that live within and outside of a 200-mile distance from pediatric ECMO programs.

43% of the total US land area falls outside of the US catchment area for pediatric ECMO; and 4.91% of the US population (or 16,433,563 persons) does not have access to a Pediatric ECMO center. One of every four individuals that identify as American Indian/Native American, one of every 100 who identify as Black/African American, one of every 12 that identify as Hispanic/Latina(o), and one of every 21 that identify as White live outside of the pediatric ECMO catchment area for the United States.

American Indian/Native Americans and Hispanic/Latina(o)s lack access to pediatric ECMO by proximity. While Black/African Americans live close to ECMO programs, previous studies show that this population has less access to primary and specialized care. Distance is one actionable measurement that should be used to extend access to medical technologies for populations that have historically been excluded.