Trauma center distribution matters: regions with more centers have better patient outcomes and lower economic costs related to injuries.

• Higher density of trauma centers correlates with lower per capita costs for fatal injuries.
• The northeast has the lowest burden of fatalities and years of potential life lost, while the south, with the fewest centers, faces the highest losses.

Optimizing trauma center allocation can significantly reduce costs and improve patient outcomes, especially in underserved areas.

• The south loses the most state income tax revenue due to inadequate trauma center distribution.