The rate of unintentional death for persons living in rural areas is approximately twice that of persons living in our largest cities (75 per 100,000 population v 37 per 100,000).1 For comparison purposes, "rural" is defined as those population centers with fewer than 50,000 persons. Two percent of the population of the United States live and work on farms, with "farm populations" being defined by the US Department of Agriculture as persons living in rural territory on places which reported sales of $1,000/yr of agricultural products. Although "rural" and "farm" are not interchangeable terms, many of the injuries incurred are similar, and it would appear that the disproportion in morbidity and mortality is due to several unique features of the rural environment.
Rural areas are by nature distant from skilled medical care, and prehospital treatment may be rudimentary or nonexistent. It is not clear from existing data sources whether the excess mortality in rural areas is due to severity of injury, inadequacy of prehospital intervention, or both.
Farming is the second most dangerous occupation in America, exceeded only by underground mining, and children and adolescents make up a significant part of the work force.2 In the years 1979 to 1981, there were nearly 300 fatal farm injuries in children younger than 19 years of age; 53% of the children died before reaching a medical facility, 19% died in transit, and 15% died at the medical facility. The location of death of the additional 13% was unclear.3
Many types of farm machinery are especially dangerous when operated by the young or inexperienced.
- Copyright © 1988 by the American Academy of Pediatrics