Injury mortality among American Indian and Alaska Native children and youth--United States, 1989-1998

Injuries account for 75% of all deaths among American Indian and Alaska Native (AI/AN) children and youth, and AI/ANs have an overall injury-related death rate that is twice the U.S. rate for all racial/ethnic populations. However, rate disparities vary by area and by cause. To help focus prevention efforts, CDC analyzed injury mortality data by Indian Health Service (IHS) administrative area and by race/ethnicity. This report summarizes the results of these analyses, which indicate that although death rates for some causes (e.g. drowning and fire) have shown substantial improvement over time, rates for other causes have increased or remained unchanged (e.g., homicide and suicide, respectively). Prevention strategies should focus on the leading causes of injury-related death in each AI/AN community, such as motor-vehicle crashes, suicides, and violence.     

Trends in injury mortality among young people in the European Union: a report from the EURORISC working group.

PURPOSE: To examine the trends in injury mortality among young people aged 15-24 years residing in the 15 current member states of the European Union between 1984 and 1993. METHODS: As part of a European Commission-funded project entitled European Review of Injury Surveillance and Control (EURORISC), mortality data for all externally caused physical injuries (International Classification of Disease Codes E800-999) were obtained from the World Health Organization. Data were analyzed to generate age-specific injury mortality rates and proportional differences in rates over the study period. Linear regression was used to represent the linear component of the mortality profile. RESULTS: Almost a quarter of a million young people died as a result of sustaining an externally caused physical injury (either unintentional or intentional) in the study countries between 1984 and 1993. Injury accounted for two-thirds of all deaths in this age group. Over three-quarters (76%) of deaths were due to unintentional injury, a further 17% to self-inflicted injuries, and the remaining 7% to homicide and other violent causes. Motor vehicle traffic fatalities accounted for 84% of unintentional injury deaths. Although a decline in injury mortality was observed throughout Europe, rates of mortality owing to both unintentional injuries and suicide varied widely among study countries at both the beginning and end of the study period. CONCLUSIONS: Whereas injury mortality rates in young people in most European countries are lower than in other parts of the world (including the United States), injuries represent a major public health problem in the European Union. The death toll from motor vehicle traffic crashes is a particular cause for concern.     

Traumatic occupational fatalities in South Carolina, 1989-90.

Death certificates for South Carolina for 1989 and 1990 were examined to identify deaths resulting from injury incurred in the workplace. There were 277 deaths in that category in the 2-year period, an average yearly rate for traumatic occupational fatalities of 8.84 per 100,000 workers. The groups of industries with the highest fatality rates were transportation-communication-utilities, construction, and agriculture-fishing-forestry. The leading causes of death were injuries from motor vehicle crash, homicide, and falls. The traumatic occupational fatality rate for men was about 13 times greater than that for women; however, a much higher proportion of women died from homicide on the job. The findings in general reflect trends reported in other studies. The death rates for workers in South Carolina for 1989-90, however, were higher than national averages for 1980-88. National data for 1989-90 were not available for comparison. The data suggest that more effective injury prevention efforts need to be applied to such causes of on-the-job injury as motor vehicle crash, homicide, and falls. Those three categories accounted for more than 56 percent of all traumatic occupational fatalities in South Carolina in 1989 and 1990. Motor vehicle crash prevention efforts particularly are needed in the transportation-communication-utilities industries. The findings show that particular efforts need to be directed to the retail trade category for prevention of homicide and to the construction industry for prevention of falls.     

Cross-national comparison of injury mortality: Los Angeles County, California and Mexico City, Mexico

BACKGROUND: Cross-national comparisons of injury mortality can suggest possible causal explanations for injuries across different countries and cultures. This study identifies differences in injury mortality between Los Angeles (LA) County, California and Mexico City DF, Mexico. METHODS: Using LA County and Mexico City death certificate data for 1994 and 1995, injury deaths were classified according to the International Classification of Diseases Ninth Revision-Clinical Modification external cause of injury codes. Crude, gender-, and age-adjusted annual fatality rates were calculated and comparisons were made between the two regions. RESULTS: Overall and age-adjusted injury death rates were higher for Mexico City than for LA County. Injury death rates were found to be higher for young adults in LA County and for elderly residents of Mexico City. Death rates for motor vehicle crashes, falls, and undetermined causes were higher in Mexico City, and relatively high rates of poisoning, homicide, and suicide were found for LA County. Motor vehicle crash and fall death rates in Mexico City increased beginning at about age 55, while homicide death rates were dramatically higher among young adults in LA County. The largest proportion of motor vehicle crash deaths was to motor vehicle occupants in LA County and to pedestrians in Mexico City. CONCLUSIONS: These findings illustrate the importance of primary injury prevention in countries having underdeveloped trauma care systems and should aid in setting priorities for future work. The high frequency of pedestrian fatalities in Mexico City may be related to migration of rural populations, differing vehicle characteristics and traffic patterns, and lack of safety knowledge. Mexico City's higher rate of fall-related deaths may be due to concurrent morbidity from chronic conditions, high-risk environments, and delay in seeking medical treatment.     

Tobacco, alcohol, and other drug use among high school students in Bureau of Indian Affairs-funded schools--United States, 2001

In the United States, use of alcohol and other drugs is associated with the three leading causes of death and disability (i.e., unintentional injuries, primarily from motor vehicle crashes; suicide; and homicide) among American Indian/Alaska Native (AI/AN) persons aged 15-24 years, and tobacco use is associated with the two leading causes of death (i.e., heart disease and cancer) among AI/AN adults. This report presents data about the prevalence of tobacco, alcohol, and other drug use among high school students at schools funded by the Bureau of Indian Affairs (BIA). The findings indicate that a substantial number of these students engage in behaviors that put them at risk for premature death and disability and underscore the need for expanded health education and counseling programs and policies in AI communities and BIA-funded schools.     

Injury fatalities among young children

Injuries and violence are the primary causes of death among young children in the United States. In particular, in 1982-84 motor vehicle injuries, fires, drowning, and homicide were the leading external causes of death at ages 1-4 years and 5-9 years, accounting for nearly 80 percent of all deaths from external causes. The purpose of this article is to analyze race and sex differentials in injury fatalities among young children. Race and sex differentials in injury mortality were measured in terms of relative risks, that is, race (black to white) and sex (male to female) mortality ratios. Race ratios for external causes ranged from 1.7 to 1.9 for children 1-4 and 5-9, while sex ratios were somewhat lower, 1.4 to 1.8. Although race and sex ratios were relatively small for passenger-related motor vehicle fatalities (0.8 to 1.2) the ratios for pedestrian-related injuries were considerably greater (1.5 to 2.0). Race ratios for deaths caused by fires and homicide were particularly large (3.4 to 4.3). Mortality differences were also measured in terms of excess mortality. For each age-race group more than 65 percent of the overall excess deaths among males were due to external causes of death. Pedestrian-related motor vehicle injuries and drownings accounted for the largest proportion of excess deaths among males. At ages 1-4, 53 percent of the overall excess deaths among blacks were due to external causes. Deaths caused by fires and homicide accounted for more than two-fifths of the excess in this age group.(ABSTRACT TRUNCATED AT 250 WORDS)     

Northeastern Ohio Trauma Study: II. Injury rates by age, sex, and cause

Using a 1977 sample of emergency department visits in five northeastern Ohio counties, population-based injury rates are tabulated by age, sex, and cause. Case fatality ratios are estimated by comparing these injury rates with population-based mortality rates for 1976-1978. For all age and sex groups, injuries are a major cause of emergency department visits. Falls, striking, cuts, and motor vehicle crashes are the leading causes of injury. Case fatality ratios for motor vehicle crash injuries are considerably higher than those for non-transport injuries. Injury rates and case fatality ratios for males exceed those for females except among the elderly. With increasing age, injury rates decline but the fraction of injuries leading to hospital admission or to fatality rises sharply.     

Children's safety on American Indian farms: information and recommendations

It is estimated that 1.2 million youth younger than age 20 live on farms; American Indian children constitute an important but understudied subset of this at-risk group. Despite documented risks of injuries and death among children who live and work on farms and a descending trend in the overall reported fatalities among youth who live and/or work on farms, very little is known about the agriculture-related injury and fatality experience of American Indian youth. Limited data indicate that drowning, motor vehicles, and poisonings are leading causes of unintentional mortality and morbidity for this group, although the attribution to agricultural exposure is not evident. The scant available data indicate a need to look more closely at agricultural work, bystander exposures, and other farm events that put American Indian youth at risk of illness, injury, or death compared to factors more fully reported for majority youth in the agriculture population, in order to guide intervention and prevention programs that are appropriate and acceptable to this vulnerable population.     

The role of race/ethnicity in alcohol-attributable injury in the United States

A substantial proportion of injuries worldwide are attributable to alcohol consumption, and US estimates indicate that the drinking patterns of racial/ethnic groups vary considerably. The authors reviewed evidence from 19 publications regarding racial/ethnic differences in overall alcohol-attributable injury as well as percent blood alcohol content positivity for injury deaths in the United States. They found that Native Americans evidence higher rates of alcohol-attributable motor vehicle crash fatality, suicide, and falls compared with other racial/ethnic groups; conversely, Asians evidence lower rates of alcohol-attributable injury than other racial/ethnic groups. The rate of alcohol positivity and intoxication among Hispanics is disproportionately high relative to estimates of alcohol use. Black subgroups also evidence higher rates of alcohol positivity than would be expected given estimates of alcohol use, including for alcohol positivity among drivers of fatally injured black children and homicide. These findings highlight the continued need for public health focus on Native American populations with respect to alcohol consumption and injury. Further, the disparity in alcohol-attributable injury mortality among black and Hispanic groups relative to their reported rates of alcohol consumption is an overlooked area of research. The authors review potential social determinants of racial/ethnic disparities in alcohol-attributable injuries and identify directions for further research on these patterns.     

蚌埠市1992～2001年儿童伤害死亡率分析

目的 描述蚌埠市0-14岁儿童伤害死亡变化趋势和特点，为开展伤害的预防和控制提供科学依据。方法 对1992-2001年蚌埠市市辖区生命统计年报资料进行分析。结果 10年间，蚌埠市0-14岁儿童伤害死亡率为12．7／10万—44．8／10万，占全死因构成的12．7％-37．4％，居0-14岁儿童全死因的前3位；伤害死亡率男性高于女性，伤害死亡率总体呈下降趋势。伤害死因别中溺水、机械性窒息和机动车交通事故是主要因素。伤害死亡率郊区高于市区。结论 0-14岁儿童伤害死亡率呈下降趋势，但仍是主要死因之一，尤其在郊区。     

Fatal work-related injuries in the U.S. chemical industry 1984–89

Several mortality studies of the chemical industry have examined fatal injuries, but most of these studies have been of employees of large chemical firms and have not separated work-related from non-work-related injuries. We examined all U.S. Occupational Safety and Health Administration (OSHA) investigation files in 1984-89 in 47 U.S. states of fatal injuries in the chemical industry, Standard Industrial Classification (SIC) 2800–2899. OSHA investigates all reported deaths over which it has jurisdiction; this includes most causes of work-related death except for homicide and motor vehicle crashes. For the 6 year period, there were 234 fatalities in the chemical industry, for a work-related fatality rate of 0.55 per 10,000 workers/year. The largest category of deaths was from explosions, with 99 (42%), followed by fire & burns, with 32 (14%), poisoning, with 31 (13%), and falls, with 18 (8%). Of the 99 deaths from explosions, 45 (45%) involved manufacture or handling of fireworks or other explosives. The fatality rate at firms with fewer than 50 employees was more than twice that of larger firms (P < 0.05) and employees at small firms were less likely to have been covered by a union contract (P < 0.05). OSHA issued citations for safety violations in 73% of the deaths. While regulatory authorities and the media often focus attention on large, multinational chemical corporations, the highest worker fatality rates are found at the smallest chemical firms.     

A comparison of injury death rates in China and the United States, 1986.

BACKGROUND: The importance of injury as a public health problem is not well recognized in many developing countries. Data have recently become available on injury mortality in China. METHOD: We compared Chinese injury data based on a 100 million population segment for 1986 with data for the United States. RESULTS: The age-adjusted death rate from all injuries for China exceeds the rate for the US (69.0 vs 61.3 per 100,000). The US has higher death rates from motor vehicle crashes, fires, and homicide; China has greater mortality from drowning, poisoning, falls, and suicide. Especially noteworthy in China are the high drowning rates among young children and the elderly and the high suicide rates in rural areas among young adults and the elderly. CONCLUSION: Injury is an important public health problem in China, exceeding in many respects the problem in the United States. It is urgent for China to place high priority on injury research and prevention.     

Homicide, suicide, motor vehicle crash, and fall mortality: United States'' experience in comparative perspective.

US mortality data on motor vehicle crashes, falls, suicide, and homicide for 1980 are compared with corresponding data for France, Japan, West Germany, and the United Kingdom. Unadjusted and age-specific death rates are presented, together with age-adjusted rates of years of life lost (YLL). A large male excess in rates is typical outside the fall category. Motor vehicle crashes are the predominant cause of YLL, and the United States manifests the highest YLL rates for each sex. US fall death rates at the older ages are exceeded by those of France and West Germany. The elderly generally manifest the greatest risk of suicide; American females exhibit a unique rate decline after ages 45-54 years, however. Beyond early adulthood, US suicide rates are lower than those of France, Japan, and West Germany. US homicide rates dwarf those of the comparison countries with 16- to 29-fold differentials separating prime-risk American males aged 25-34 years from their foreign counterparts.     

Alcohol and fatal injuries: temporal patterns

Although alcohol use has been established as a risk factor for injuries associated with motor vehicle crashes, the role of alcohol for other unintentional and intentional injuries is less defined. A review of 102,401 deaths investigated by North Carolina medical examiners in the period 1973-1983 characterized the temporal patterns of ethyl alcohol in unintentional injury fatalities, suicides, homicides, and persons who died of natural or unknown causes. Victims of homicides (85.9%) and suicides (77.7%) were tested for alcohol more frequently than were fatalities resulting from unintentional injury (67.5%) or natural causes (61.6%). Alcohol was present in 62.8% of homicide victims, 48.6% of unintentional injury fatalities, 35.3% of suicides, and 14.4% of deaths from natural causes. The percentage of alcohol-associated deaths for each manner of death showed little yearly or seasonal variation. Alcohol was most frequently detected in persons fatally injured on the weekend and from 6 PM to 6 AM. This study highlights the magnitude of alcohol's role in intentional and unintentional injuries, especially for persons injured at night and on weekends.     

Childhood injury deaths: national analysis and geographic variations.

Twenty-three causes of injury mortality in children ages 0-14 in the United States were analyzed by age, race, sex, and state of residence for the years 1980-85. Motor vehicles caused 37 per cent of all injury-related deaths and were the leading cause of injury mortality in every group except children younger than one year, for whom homicide was the leading cause. Male death rates were at least four times female rates for suicide, unintentional firearm injury, and injuries related to farm machinery or motorcycles. The drowning rate among Whites was almost twice that of Blacks for ages 1-4, but in the 10-14 year age group the drowning rate for Blacks was over three times that of Whites. In general, the highest injury death rates were in the mountain states and the south. Between 1980 and 1985, the suicide rate in the 10-14 year age group more than doubled.     

Trends in motor vehicle traffic fatalities among Hispanics,non‐Hispanic whites and American Indians in New Mexico, 1958–1990

Objective. New Mexico has had the highest motor vehicle fatality rate in the nation for many years. Our objective was to examine ethnic differences and trends in motor vehicle fatality rates.

Design. Using death certificate data from the New Mexico Bureau of Vital Records and Health Statistics, we compiled age‐adjusted motor vehicle‐related mortality rates from 1958–1990 among the three major ethnic groups in New Mexico—Hispanics, white non‐Hispanics and American Indians.

Results. Over the 33‐year study period, American Indians of both sexes had two to three times higher mortality rates than white non‐Hispanics. Hispanic males also had higher motor vehicle death rates than white non‐Hispanic males. During the 1970s fatality rates peaked, with age‐adjusted death rates of 233/100 000 for American Indian males, 74.7 for Hispanic males and 49.3 for white non‐Hispanics for the period 1973–1977. Evaluation of successive 5‐year birth cohorts showed highest mortality rates for ages 15–29 years for each ethnic group and both sexes, and a dramatic decline in most ethnic, sex and age‐specific rates during the last eight years of the study period.

Conclusion. Although the recent trends indicate favorable changes in motor vehicle fatality rates, our data highlight the need for ethnic and age‐specific interventions to further reduce rates of motor vehicle‐related mortality in this state.     

Acute traumatic injuries in rural populations

In the United States, injuries are the leading cause of death among individuals aged 1 to 45 years and the fourth leading cause of death overall. Rural populations exhibit disproportionately high injury mortality rates. Deaths resulting from motor vehicle crashes, traumatic occupational injuries, drowning, residential fires, and suicide all increase with increasing rurality. We describe differences in rates and patterns of injury among rural and urban populations and discuss factors that contribute to these differences.     

US childhood mortality, 1950 through 1993: Trends and socioeconomic diffferentials.

OBJECTIVES: This study examined trends and differentials in US childhood mortality from 1950 through 1993 according to sex, race/ethnicity, education, family income, and cause of death. METHODS: Log-linear, multiple regression, and Cox proportional hazards regression models were applied to the data from the National Vital Statistics System, the National Longitudinal Mortality Study, and the Area Resource File. RESULTS: Substantial declines in US childhood mortality have occurred in the past 4 decades, primarily due to decreases in mortality from unintentional injuries, cancer, pneumonia and influenza, and congenital anomalies. The overall declining trend, however, has been dampened by a twofold to threefold increase in the suicide and homicide rates among children since 1968. Male, Black, American Indian, Hawaiian, and Puerto Rican children and those in the lower socioeconomic strata were at an increased risk of death. CONCLUSIONS: Increasing trends in mortality from violence, firearm injuries, and human immunodeficiency virus/acquired immunodeficiency syndrome pose a major obstacle to continued declines in US childhood mortality. Reducing socioeconomic disparities and improving access to and use of health care may bring about further declines in overall and injury-related childhood mortality.     

Nonfatal injuries and restraint use among child passengers--United States, 2004

During 1978-2004, annual rates of child fatalities from motor vehicle crashes (MVCs) declined from 31.8 to 22.3 deaths per million. This decline might be partially attributed to the increased use of both child safety seats (for infants and young children) and seatbelts (for older children). Nevertheless, among child passengers aged 相似文献   

我国车祸的流行病学特征及影响因素分析

本研究的目的在于分析1951～1994年我国车祸的流行病学特征及其影响因素，为车祸的预防和控制提供依据。43年中我国车祸发生数增加了42倍，死亡人数增加了77倍。1984～1994年车祸年死亡率由2．43／10万人上升到5．56／10万人，平均年增长率为12．9％。广东、浙江、辽宁、四川和江苏是车祸最多的省份，5省的车祸发生数占全国总发生数45％，死亡人数占38％。1994年30个省市区的车祸死亡率以北京市为最低（3．41／10万人），浙江省最高（12．09／10万人），广东省的升幅最大。致死性车祸多发生于天气晴朗时的平直路段，以20～50岁的农民和职工居多，死者2／3为行人、骑自行车者和乘车者。各类事故的原因中驾驶员责任、无证开车、骑自行车人责任和行人过失等人的因素占90％。驾驶员肇事原因主要是违章行车、判断错误或疏忽大意。车辆增加、运输繁忙和道路不足、交通条件欠完善是导致车祸的主要因素。预防和控制车祸的根本措施在于改善交通环境和加强交通安全教育。