Burns, borders, and comorbidities: a regional analysis of medical comorbidities in Texas and New Mexico burn patients

Background: Burn injuries impose a substantial public health burden, with medical comorbidities playing a crucial role in influencing clinical outcomes, resource utilization, and overall patient trajectories. Given the stark differences in socioeconomic and healthcare landscapes between Texas (TX) and New Mexico (NM), examining the distribution of comorbidities among burn patients from these neighboring states provides valuable insights into regional health disparities. Objective: This study aims to elucidate the association between specific medical comorbidities and state of residence (TX versus NM) in a cohort of burn patients treated at a major regional burn center serving West Texas and surrounding areas. Methods: A retrospective analysis of 2,017 burn patients treated between 2019 and 2024 was conducted using multivariable logistic regression. State of residence was the outcome variable, and ten prevalent comorbidities (≥5% prevalence) were modeled as predictors, following collinearity and prevalence screening. Results: The overall model demonstrated strong statistical significance (likelihood ratio test p < 0.001). Notably, chronic obstructive pulmonary disease (COPD), substance use disorder, and alcohol use disorders were significantly associated with higher odds of residence in New Mexico (all p < 0.02). Comorbidities including diabetes mellitus, obesity, hypertension, and hyperlipidemia showed no significant differences between states. Conclusion: The novel finding of increased burden of respiratory and substance-related comorbidities among burn patients from New Mexico likely reflects underlying regional health inequities driven by socioeconomic factors and disparities in healthcare access. These findings underscore the importance of tailored public health strategies and resource allocation to address state-specific patient needs in burn care and overall physical wellbeing.