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Sociodemographic factors identify US infants at high risk of injury mortality
S J Scholer1, G B Hickson, W A Ray
1Department of Pediatrics, Vanderbilt University, Nashville, Tennessee, USA. seth.scholer@mcmail.vanderbilt.edu
Insights
Infant injury mortality is predicted by maternal age, education, marital status, number of children, and birth weight. High-risk infants face over 10 times the mortality risk, with no narrowing disparity observed.
Area of Science:
- Public Health
- Epidemiology
- Pediatrics
Background:
- Infant injury mortality remains a significant public health concern.
- Identifying at-risk populations is crucial for targeted prevention strategies.
Purpose of the Study:
- To determine sociodemographic factors predicting infant injury mortality.
- To compare injury mortality trends in high-risk versus low-risk US infants (1985-1991).
Main Methods:
- Historical cohort study utilizing linked birth and death certificate data (National Center for Health Statistics).
- Multivariate regression analysis identified sociodemographic predictors.
- Infants categorized into risk groups based on maternal age, education, marital status, number of siblings, and birth weight.
Main Results:
- Sociodemographic factors significantly associated with infant injury mortality include maternal age, education, number of other children, marital status, and infant birth weight.
- Infants in the highest risk group (21% of population) had over a 10-fold increased risk of injury mortality compared to the lowest risk group (18.1%).
- The disparity in injury mortality risk between high- and low-risk groups did not narrow during the study period (1985-1991).
Conclusions:
- Sociodemographic factors are key predictors of infant injury mortality, allowing for identification of high-risk infants at birth.
- Approximately 1 in 5 US infants can be identified as having a significantly elevated risk for injury mortality.
- Urgent development and implementation of targeted injury prevention programs for high-risk infant populations are necessary.
Objectives:
To identify sociodemographic predictors of infant injury mortality and to compare trends in injury mortality rates for high- and low-risk US infants from 1985 to 1991.
Design:
Historical cohort. SETTING/STUDY PARTICIPANTS: The National Center for Health Statistics linked US infants (<1 year) born from 1985 to 1991 with death certificates.
Main Outcome Measures:
Multivariate regression was used to identify sociodemographic factors associated with injury mortality. The adjusted relative risks (RRs) of maternal age, education, marital status, number of other children, and infant birth weight were used to categorize infants into risk groups. We compared trends in injury rates for the highest and lowest risk groups.
Results:
There were 5963 injury deaths and 18.6 million infant years or 32.1 injury deaths per 100 000 infant years. Highest risk infants were born to mothers who were younger than 20 years compared with older than 30 years (RR, 3.25; 95% CI, 2.92-3.63), had less than a high school education compared with a college education (RR, 2.22; 95% CI, 1.95-2.53), had more than 2 other children compared with no other children (RR, 3.15; 95% CI, 2.88-3.45), were unmarried (RR, 1.67; 95% CI, 1.57-1.78), or had birth weights 2500 g (RR, 3.36; 95% CI, 2.94-3.84). Infants in the highest risk group (21.0% of the population) had a >10-fold increased risk of injury mortality compared with the lowest risk group (18.1% of the population) and there was no evidence that this disparity was narrowing.
Conclusions:
Sociodemographic predictors of infant injury mortality include maternal age, education, number of other children, marital status, and infant birth weight. Based on these factors, 1 in 5 infants in the United States can be identified at birth as having a >10-fold increased risk of injury mortality compared with infants in lowest risk group. Programs to reduce injuries in these high-risk groups are urgently needed.