Citation

Reading R. Child Care Health Dev. 2007; 33(5): 647.

Copyright

(Copyright © 2007, John Wiley and Sons)

DOI

10.1111/j.1365-2214.2007.00778_1.x

PMID

17725791

Abstract

Objective Mortality trends across modifiable injury mechanisms may reflect how well effective injury prevention efforts are penetrating high-risk populations. This study examined all-cause, unintentional and intentional injury-related mortality in children who were aged 0-4 years for evidence of and to quantify racial disparities by injury mechanism. Methods Injury analyses used national vital statistics data from 1 January 1981 to 31 December 2003 that were available from the Centers for Disease Control and Prevention. Rate calculations and chi-squared test for trends (Mantel extension) used data that were collapsed into 3-year intervals to produce cell sizes with stable estimates. Percentage change for mortality rate ratios used the earliest (1981-1983) and the latest (2001-2003) study periods for black, American Indian/Alaskan Native and Asian/Pacific Islander children, with white children as the comparison group. Results All-cause injury rates declined during the study period, but current mortality ratios for all-cause injury remained higher in black and American Indian/Alaskan Native children and lower in Asian/Pacific Islander children compared with white children. Trend analyses within racial groups demonstrated significant improvements in all groups for unintentional but not intentional injury. Black and American Indian/Alaskan Native children had higher injury risk as a result of residential fire, suffocation, poisoning, falls, motor vehicle traffic and firearms. Disparities narrowed for residential fire, pedestrian and poisoning, and widened for motor vehicle occupant, unspecified motor vehicle and suffocation for black and American Indian/Alaskan Native children. Conclusions These findings identify injury areas in which disparities narrowed, improvement occurred with maintenance or widening of disparities, and little or no progress was evident. This study further suggests specific mechanisms whereby new strategies and approaches to address areas that are recalcitrant to improvement in absolute rates and/or narrowing of disparities are needed, and where increased dissemination of proven efficacious injury prevention efforts to high-risk populations are indicated.

Language: en