Children with life-threatening illness need urgent, high-quality, hospital care. In BC, regions with the highest rates of child death are the furthest from specialized pediatric hospitals. Healthcare providers in local community hospitals initiate treatment for sick children. Children who need specialized care are transported to one of two pediatric intensive care units (PICU) in BC, in Vancouver and Victoria. Canadian research suggests needing transport to access PICU care could increase a sick child’s risk of dying. Inequitable access to care may lead to inequitable outcomes for children in our province. I propose to 1) Describe geographic differences in rates of life-threatening illness among children in BC, 2) Describe what happens to children with life-threatening illness in the hospital and after they go home, and 3) partner with patients, families, communities, and healthcare providers to evaluate health equity stratifiers that may be associated with a child’s risk of developing life-threatening illness or their outcome due to systemic inequity. Our research will improve understanding of the healthcare needs of sick children in BC and inform initiatives to ensure that all children have the best care and chance of recovery.