Citation

Veras Y, Rogers ML, Smego R, Zonfrillo MR, Mello MJ, Vivier PM. Acad. Pediatr. 2019; 19(6): 677-683.

Affiliation

Hassenfeld Child Health Innovation Institute, 121 South Main Street, Box G S 121-4, Providence, RI, USA 02912; The Injury Prevention Center at Rhode Island Hospital and Hasbro Children's Hospital, 55 Claverick Street, 2nd Floor, Providence, RI, USA 02903; Department of Health Services, Policy, and Practice, Brown University, Providence, RI 02912; Department of Pediatrics, The Warren Alpert Medical School of Brown University, Providence, RI 02912. Electronic address: Patrick_vivier@brown.edu.

Copyright

(Copyright © 2019, Academic Pediatric Association, Publisher Elsevier Publishing)

DOI

10.1016/j.acap.2018.11.012

PMID

30496868

Abstract

BACKGROUND: Falls represent the leading cause of nonfatal unintentional injuries among children in the U.S. While unintentional injury risks have been studied, neighborhood impact on falls remains underexplored. This study examined the association of neighborhood attributes with rates of fall-related injuries.

METHODS: This is a retrospective study of children who presented to Emergency Departments (EDs) within a state-wide hospital network for fall-related injuries between 2005-2014. Patients' home addresses were geocoded to identify Census block groups (BG). Average annual fall rates were computed for each BG. A neighborhood risk index was constructed using eight socioeconomic BG measures (education, crowding, vacancy, renter-occupancy, poverty, family structure, race/ethnicity, and housing age). Public outdoor recreational facilities in each BG were enumerated. Linear regression analysis was used to assess the association of neighborhood risk and recreational facilities with fall rates.

RESULTS: From 2005-2014, there were 139,986 unintentional injury ED visits; 42,365 (30%) were for falls. The largest proportion of falls were among males (58%), children aged 1-4 years (39%), non-Hispanic whites (59%), and children with public health insurance (53%). Higher quintiles of neighborhood risk were associated with higher annual fall rates (compared to the lowest quintile of risk, Quintile 2 β=0.44; CI 0.20-0.68, Quintile 3 β=0.85; CI 0.61-1.10, Quintile 4 β=1.11; CI 0.85-1.37, Quintile 5 β=1.57; CI 1.29-1.85). The presence of public outdoor recreational facilities was not associated with fall rates (β=0.01; CI -0.14-0.15).

CONCLUSION: Neighborhood-level socioeconomic characteristics are associated with higher fall-related injuries. Injury prevention programs could be tailored to address these neighborhood risks.

Copyright © 2018. Published by Elsevier Inc.

Language: en

Keywords

child health; falls; pediatric injury; spatial analysis