This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Scholer, S. J.
Right arrow Articles by Ray, W. A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Scholer, S. J.
Right arrow Articles by Ray, W. A.
Related Collections
Right arrow Office Practice

PEDIATRICS Vol. 100 No. 3 September 1997, pp. 342-347

Predictors of Injury Mortality in Early Childhood

Received Oct 28, 1996; accepted Dec 30, 1996.

Seth J. Scholer*, Edward F. Mitchel JrDagger , and Wayne A. RayDagger

From the Division of General Pediatrics, Departments of * Pediatrics and Dagger  Preventive Medicine, Vanderbilt University, Nashville, Tennessee.

Objective.  To study the association between maternal/infant characteristics and mortality from injury for children 0 through 4 years of age.

Design.  Historical cohort.

Setting.  State of Tennessee.

Participants.  Children 0 through 4 years of age at any time between January 1, 1985 and December 31, 1994. We linked birth certificates and US census data to obtain information on maternal age, race, education, neighborhood income, parity, use of prenatal care, residence location, infant's gender, and gestational age.

Main Outcome Measures.  The outcome was death from injury, as determined from linked death certificates. The incidence density rates for each stratum (defined by maternal/child characteristics) were calculated by dividing the number of injury deaths by child years in the stratum. We used multivariate analysis to assess the independent contribution of each characteristic to risk of injury death.

Results.  There were 1 035 504 children 0 through 4 years of age who contributed 3 414 436 child years. There were 803 deaths from injury, ie, 23.5 deaths per 100 000 child years. In the multivariate analysis, children had at least a 50% increased risk of injury mortality if they were born to a mother who had less than a high school education (relative risk [RR] = 2.88; 95% confidence interval [CI]: 1.92-4.34) compared with a college education, was <20 years of age (RR = 2.42; 95% CI: 1.76-3.31) compared with >30 years, or had >2 other children (RR = 2.97; 95% CI: 2.29-3.85) compared with no other children. Neither race nor income was significantly associated with childhood injury mortality in the multivariate analysis. Classification of children by maternal education, age, and parity defined a pronounced risk gradient in which high-risk children had an injury mortality rate >15 times that of low-risk children. The steep risk gradient was present for both infants (24-fold increase for high-risk children) and children 1 through 4 years of age (13-fold increase for high-risk children). If the injury mortality rate for all children were equal to that of the low-risk group, 614/803 (76.3%) of injury deaths would not have occurred.

Conclusions.  For young children, maternal education, age, and parity are strongly and independently associated with injury mortality. These factors define a steep gradient of risk, suggesting that many injury deaths could be prevented.

Key words: wounds and injuries, socioeconomic factors, risk factors.




This article has been cited by other articles:


Home page
 J. Epidemiol. Community HealthHome page
M.-H. Kim, S V Subramanian, I. Kawachi, and C.-Y. Kim
Association between childhood fatal injuries and socioeconomic position at individual and area levels: a multilevel study
J. Epidemiol. Community Health, February 1, 2007; 61(2): 135 - 140.
[Abstract] [Full Text] [PDF]

Home page
 Journal of Early Childhood ResearchHome page
B. S. Roudsari, G. H. Utter, M. A. Kernic, and B. A. Mueller
Risk of early childhood injuries in twins and singletons
Journal of Early Childhood Research, June 1, 2006; 4(2): 121 - 131.
[Abstract] [PDF]

Home page
 J Pediatr PsycholHome page
B. A. Morrongiello
Caregiver Supervision and Child-Injury Risk: I. Issues in Defining and Measuring Supervision; II. Findings and Directions for Future Research
J. Pediatr. Psychol., October 1, 2005; 30(7): 536 - 552.
[Abstract] [Full Text] [PDF]

Home page
 J. Epidemiol. Community HealthHome page
C. Ekeus, K. Christensson, and A. Hjern
Unintentional and violent injuries among pre-school children of teenage mothers in Sweden: a national cohort study
J. Epidemiol. Community Health, August 1, 2004; 58(8): 680 - 685.
[Abstract] [Full Text] [PDF]

Home page
 HEALTH PROMOT INTHome page
K. Guldbrandsson and S. Bremberg
A study of safety-promoting activities for children and adolescents in 25 Swedish municipalities
Health Promot. Int., June 1, 2004; 19(2): 215 - 226.
[Abstract] [Full Text] [PDF]

Home page
 CMAJHome page
D. N. Juurlink, M. Tenenbein, G. Koren, and D. A. Redelmeier
Iron poisoning in young children: association with the birth of a sibling
Can. Med. Assoc. J., June 10, 2003; 168(12): 1539 - 1542.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Public HealthHome page
J. P. Marcin, M. S. Schembri, J. He, and P. S. Romano
A Population-Based Analysis of Socioeconomic Status and Insurance Status and Their Relationship With Pediatric Trauma Hospitalization and Mortality Rates
Am J Public Health, March 1, 2003; 93(3): 461 - 466.
[Abstract] [Full Text] [PDF]

Home page
 J. Epidemiol. Community HealthHome page
A Hjern and S Bremberg
Social aetiology of violent deaths in Swedish children and youth
J. Epidemiol. Community Health, September 1, 2002; 56(9): 688 - 692.
[Abstract] [Full Text] [PDF]

Home page
 Int J EpidemiolHome page
R. Gofin, M. Avitzour, Z. Haklai, and N. Jellin
Injury inequalities: morbidity and mortality of 0-17 year olds in Israel
Int. J. Epidemiol., June 1, 2002; 31(3): 593 - 599.
[Abstract] [Full Text] [PDF]

Home page
 Inj. Prev.Home page
H McPhillips, M Gallaher, and T Koepsell
Children hospitalized early and increased risk for future serious injury
Inj. Prev., June 1, 2001; 7(2): 150 - 154.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
T. G. O'Connor, L. Davies, J. Dunn, J. Golding, and the ALSPAC Study Team
Distribution of Accidents, Injuries, and Illnesses by Family Type
Pediatrics, November 1, 2000; 106(5): 68e - 68.
[Abstract] [Full Text]

Home page
 Inj. Prev.Home page
M. Bobak, H. Pikhart, and I. Koupilova
Maternal socioeconomic characteristics and infant mortality from injuries in the Czech Republic 1989-92
Inj. Prev., September 1, 2000; 6(3): 195 - 198.
[Abstract] [Full Text] [PDF]

Home page
 Inj. Prev.Home page
T. Faelker, W. Pickett, and R. J Brison
Socioeconomic differences in childhood injury: a population based epidemiologic study in Ontario, Canada
Inj. Prev., September 1, 2000; 6(3): 203 - 208.
[Abstract] [Full Text] [PDF]

Home page
 Inj. Prev.Home page
A. B Nathens, M. J Neff, C. H Goss, R. V Maier, and F. P Rivara
Effect of an older sibling and birth interval on the risk of childhood injury
Inj. Prev., September 1, 2000; 6(3): 219 - 222.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
S. J. Scholer, G. B. Hickson, and W. A. Ray
Sociodemographic Factors Identify US Infants at High Risk of Injury Mortality
Pediatrics, June 1, 1999; 103(6): 1183 - 1188.
[Abstract] [Full Text]

Home page
 PediatricsHome page
R. A. Brenner, M. D. Overpeck, D. A. C. Trumble, R. DerSimonian, and H. Berendes
Deaths Attributable to Injuries in Infants, United States, 1983-1991
Pediatrics, May 1, 1999; 103(5): 968 - 974.
[Abstract] [Full Text]

Home page
 Evid. Based Nurs.Home page
Other Articles Noted
Evid. Based Nurs., October 1, 1998; 1(4): 100 - 104.
[Full Text]

Home page
 PediatricsHome page
S. J. Scholer, G. B. Hickson, E. F. Mitchel Jr, and W. A. Ray
Predictors of Mortality From Fires in Young Children
Pediatrics, May 1, 1998; 101 (5): e12 - e12.
[Abstract] [Full Text] [PDF]

Home page
 Inj. Prev.Home page
Journal Citations
Inj. Prev., March 1, 1998; 4(1): 81 - 83.
[Full Text] [PDF]