Contributed to by PISC Senior Scholar Michael Nance, MD, Executive Committee member Daniel N. Holena, MD, Senior Scholar Elinore Kaufman, MD, MSHP, and Internal Advisory Board member Patrick Reilly, MD, this study aimed to measure the association between variable access to pediatric trauma care and motor vehicle crash (MVC) mortality in children at the US county level. After analyzing data from the NHTSA Fatality Analysis Reporting System, it found that during the study period of 2014-2018, 3,067 children died in fatal crashes. Significant disparities were also found in access to the 188 pediatric trauma centers -- 99% of pediatric trauma centers were situated in population-dense urban counties, while 28% of children lived in counties no trauma center. After risk adjustment, counties with pediatric trauma centers had significantly lower rates of pediatric MVC death than those with no trauma center. The study concludes that the presence of pediatric trauma and adult level 1/2 trauma centers are associated with lower rates of MVC death in children, implying that addressing disparities in county-level access to pediatric trauma care may be a promising avenue.