If they were to be seriously injured, many Americans would have to travel an hour or more to reach a trauma center, according to a new report in this week’s Journal of the American Medical Association.

Dr. Charles C. Branas, from the University of Pennsylvania in Philadelphia, and colleagues analyzed data from two national trauma databases, current as of January 2005.

The investigators found that 69 percent of US residents lived within 45 minutes of a level I or II trauma center, and 84 percent were within 60 minutes.

Those figures mean that 46.7 million residents - mostly in rural areas - could not reach a center within 1 hour. Conversely, quick access to numerous trauma centers was associated with urban living.

Roughly 27 percent of Americans had access to a level I or II center within 45 or 60 minutes only by helicopter, the report indicates. Up to 3 percent of US residents could only reach a trauma center outside their home states.

“Selecting trauma centers based on geographic need, appropriately locating medical helicopter bases, and establishing formal agreements for sharing trauma care resources across states should be considered to improve access to trauma care in the US,” the team suggests.

JAMA 2005;293:2626-2633.