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Injury hospitalizations among American Indian youth in Washington
S J Johnson1, M Sullivan, D C Grossman
1Harborview Injury Prevention and Research Center, Seattle, WA 98104, USA.
Insights
American Indian and Alaska Native (AI/AN) youth in Washington experience higher injury hospitalization rates than other youth. Motor vehicle incidents and assaults showed the greatest disparities, highlighting a need for targeted prevention strategies.
Area of Science:
- Public Health
- Epidemiology
- Injury Prevention
Background:
- Injury remains a significant public health concern among youth.
- Understanding disparities in injury hospitalization rates is crucial for targeted interventions.
Purpose of the Study:
- To determine the incidence and causes of injury hospitalizations among American Indian and Alaska Native (AI/AN) youth in Washington State.
- To compare these rates with those of non-AI/AN youth.
Main Methods:
- Retrospective analysis of Washington State hospital discharge data (1990-1994) for injuries (ICD codes 800-995) in individuals aged 0-19.
- Linking hospital data with Indian Health Service (IHS) patient registration to identify AI/AN youth.
- Calculating incidence ratios (IRs) to compare hospitalization rates between AI/AN and all youth.
Main Results:
- AI/AN youth had a higher injury hospitalization rate (507 per 100,000) compared to all youth (IR = 1.30).
- Motor vehicle injuries (IR = 1.73) and intentional injuries (IR = 1.71) showed the largest disparities.
- AI/AN adolescents aged 15-19 experienced the greatest disparity in injury hospitalization rates (IR = 1.4).
Conclusions:
- AI/AN youth in Washington face a disproportionately higher burden of injury hospitalizations.
- Targeted prevention efforts for motor vehicle injuries and assaults are urgently needed for this population.
- Linked hospital discharge and IHS data are effective for public health surveillance of AI/AN health outcomes.
Objective:
To determine the rate and causes of hospitalizations for injury among American Indian and Alaska Native (AI/AN) youth in the state of Washington, and to compare this with the rate of hospitalizations for injury among youth of all races.
Methods:
Subjects were aged 0-19 years and were admitted to civilian hospitals for care of an injury (International Classification of Diseases N codes 800-995) in Washington between 1990 and 1994. Deaths occurring in the prehospital setting and emergency department are not included. Using several fields of identifying information, the Washington state hospital discharge database was linked with the Indian Health Service (IHS) patient registration database to identify AI/AN youth. Denominator data included the total age specific IHS user population for American Indians and US Census derived population estimates. Incidence ratios (IRs) were calculated to compare rates of hospitalization between AI/AN youth and all youth in Washington.
Results:
A total of 694 and 29,048 hospitalizations for injury were identified for AI/AN youth and all races, respectively. The rate of hospitalization for injuries among AI/AN youth was 507 discharges per 100,000 youth (IR = 1.30; 95% confidence interval (CI) 1.20 to 1.40. The leading mechanism of injury was motor vehicles (IR 1.73, CI 1.49 to 2.01), followed by falls (IR 0.95, CI 0.79 to 1.15), and poisoning (IR 1.20, CI 0.80 to 1.78). The disparity was greater for intentional injuries (IR 1.71, CI 1.44 to 2.04). The highest IR for all unintentional injuries was for injuries from fire (IR 2.35, CI 1.42 to 3.87). AI/AN children aged 15-19 had the greatest disparity for rates of injury hospitalization (IR 1.4, CI 1.25 to 1.56).
Conclusion:
AI/AN youth in Washington had a higher hospitalization rate for injury compared with all youth in the state. Disparities were greatest for injuries related to motor vehicles and assaults. When linked, hospital discharge data can be used for surveillance of AI/AN hospitalizations.