Intentional Injuries among Children and Adolescents in Massachusetts

Guyer, Bernard; Lescohier, Ilana; Gallagher, Susan Scavo; Hausman, Alice J.; Azzara, Carey V.

doi:10.1056/nejm198912073212306

Cited by 49 publications

(13 citation statements)

References 15 publications

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“…Two studies used the same data source (Northern Manhattan Injury Surveillance System) to examine severe injuries (those resulting in hospitalization or death) but utilized two different levels of analysis: zip code of residence (23) and census tract (22). Both studies found that low SES was associated with higher injury rates among persons ages 16 and under. For the studies examining cause-specific nonfatal injuries, rates were higher in areas characterized by low SES, or inversely correlated with SES measures for head injuries (24,41,60), fire or burn injuries (32,47), pedestrian or bicyclist injuries (21,63), and intentional nonfatal injuries (28), regardless of study population and setting, source of data, covariates, or SES measure(s) used. Two of the individual-level studies examined the relationship between SES and nonfatal injuries by gender.…”

Section: Nonfatal Injuriesmentioning

confidence: 99%

Socioeconomic Inequalities in Injury: Critical Issues in Design and Analysis

Cubbin

Smith²

2002

Annu. Rev. Public Health

219

145

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s Abstract Injuries continue to place a tremendous burden on the public's health and rates vary widely among different groups in the population. Increasing attention has recently been given to the effects of socioeconomic status (SES) as a determinant of health among both individuals and communities. However, relatively few studies have focused on the influence of SES and injuries. Furthermore, those that have, and the other injury studies that have included measures of SES in their analysis, have varying degrees of conceptual and methodological rigor in their use of this measure. Recent advances in data linkage and analytic techniques have, however, provided new and improved methods to assess the relationship between SES and injuries. This review summarizes the relevant literature on SES and injuries, with particular attention to study design, and the measurement and interpretation of SES. We found that increasing SES has a strong inverse association with the risk of both homicide and fatal unintentional injuries, although the results for suicide were mixed. However, the relationship between SES and nonfatal injuries was less consistent than for fatal injuries. We offer potential explanatory mechanisms for the relationship between SES and injuries and make recommendations for future research in this area.

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Section: Nonfatal Injuriesmentioning

confidence: 99%

Socioeconomic Inequalities in Injury: Critical Issues in Design and Analysis

Cubbin

Smith²

2002

Annu. Rev. Public Health

219

145

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“…Females were more likely to be transported for suicide and drug intoxication, whereas males were more likely to be transported for assault and alcohol. Male overrepresentation in assault situations has been previously described 14,16,17 and is not, therefore, surprising. Our nearly equal female representation in transport for drug intoxication is consistent with studies reporting that girls experiment with drugs at younger ages than boys do.…”

Section: Discussionmentioning

confidence: 53%

Disturbing TrendsThe Epidemiology of Pediatric Emergency Medical Services Use

Sapién

Fullerton

Olson

et al. 1999

Academic Emergency Medicine

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Abstract. Objective: To compare pediatric ambulance patients transported for chief complaints of suicide, assault, alcohol, and drug intoxication (SAAD) with pediatric patients transported for all other chief complaints. Methods: An out-of-hospital database for the primary transporting service in an urban area was analyzed for patients 0 -20 years of age from 1992 to 1995. Chief complaints by age, gender, and billing status were analyzed. Results: There were 17,722 transports. The SAAD group comprised 14.9% of all transports (suicide attempt 1.6%, assault 5.9%, alcohol intoxication 3.2%, and drug abuse 4.2%). The proportion of transports due to SAAD increased with age: 0 -11-year-olds (4.2%); 11 -16-year-olds (17.5%); and 17 -20-year-olds (20.3%) (p = 0.0001). Genders were equally represented in the overall group, while males comprised 52.6% of the SAAD transports (p = 0.032). In the SAAD group, the majority of transports for assaults (55.9%) and alcohol (58.8%) involved males, while females were the majority in transports for suicide (52.3%) and drug abuse (66%) (p = 0.0001). Reimbursement sources differed, with those in the SAAD group less likely to be reimbursed by private or public (Medicaid, government) insurance (p < 0.0001) compared with the overall group. Conclusions: A substantial proportion of pediatric emergency medical services transports are for high-risk conditions. This patient population differs from the overall group by age distribution and reimbursement source. Key words: EMS; pediatrics; injuries; suicide; alcohol abuse; epidemiology. ACADEMIC EMER- GENCY MEDICINE 1999; 6:232 -238 T HE EPIDEMIOLOGY of the pediatric emergency medical services (EMS) population has been described. 1 -7 The existing studies usually describe the pediatric EMS population by age group and major category (medical vs trauma) for transport.Of concern in this population are adolescents who are at risk for experiencing injury morbidity and mortality. In fact, trauma is the leading cause for EMS/hospital use by and death of adolescents. 8 -10 This is partially explained by the risktaking behaviors in this population such as nonuse of seat belts, fighting, alcohol use, 11 and lethal weapon possession. 12 Our study was conducted to evaluate the specific reason for EMS transport (i.e., chief complaint) of pediatric patients, and to provide specific information about pediatric EMS patients. Such information might provide guidance for planning interventions, especially for potential high-risk EMS patients such as those transported for violence or substance abuse. Based on existing literature, we hypothesized that the four high-risk issues of suicide, assault, alcohol, and drug intoxication (SAAD) would be leading causes of ambulance transports among older pediatric patients. We further hypothesized that patients transported for these SAAD chief complaints would be disproportionately male and more likely to have public insurance as their reimbursement source than would patients transported for other reasons. METHODSStudy De...

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“…Each year in Massachusetts, 1 in 303 female adolescents received hospital care for a suicide attempt, and drug overdose was the method used most often for these attempts (Guyer et al, 1989). More than one third of ingestions by adolescents involve over the counter medications such as aspirin and one quarter involve psychotropic medications or sedatives (Guyer et al, 1989 andTrinkoff &Baker, 1986).…”

Section: Poisoningmentioning

confidence: 99%

Injuries to Women in the United States

Schnitzer

Runyan

1995

Women & Health

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This review summarizes the descriptive epidemiology of injuries among women in the United States, highlighting major problems as well as needs and opportunities for intervention and research. Injury mortality rates for 1984-88 were calculated from the National Center for Health Statistics mortality data tapes. Additional injury mortality and all injury morbidity information were derived from existing literature. Studies providing gender-specific U.S. injury information during the last ten years were reviewed. Injuries are the leading causes of death for females to age 34 and are responsible for more years of potential life lost than any other cause of death. The lifetime cost of injuries to females is approximately 50 billion dollars annually. Motor vehicle related injuries, falls, and violence are the most significant injury problems for women. Although morbidity is far greater than mortality, access to information about nonfatal injuries is extremely limited. What evidence does exist points to the importance of domestic assault as a major, underrecognized source of preventable injury. Though the greater magnitude of injury among men frequently eclipses the significance of injury as a problem for women, this paper presents evidence that injury is a problem which should feature prominently in the women's health agenda for the nation. There are pressing research needs to understand the changing trends in injuries to females and to identify appropriate intervention strategies. In addition, the study points to the needs for improvement in data systems to document injury morbidity.

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Intentional Injuries among Children and Adolescents in Massachusetts

Cited by 49 publications

References 15 publications

Socioeconomic Inequalities in Injury: Critical Issues in Design and Analysis

Socioeconomic Inequalities in Injury: Critical Issues in Design and Analysis

Disturbing TrendsThe Epidemiology of Pediatric Emergency Medical Services Use

Injuries to Women in the United States

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