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Severe injury among Hispanic and non-Hispanic white children in Washington state
Catherine J Karr1, Frederick P Rivara, Peter Cummings
1Department of Pediatrics, University of Washington School of Medicine, Seattle, WA 98195-9739, USA. ckarr@u.washington.edu
Insights
Hispanic and non-Hispanic white children have similar overall rates of traumatic injury. However, Hispanic children experience higher rates of burns, gun injuries, and cuts, indicating a need for targeted prevention strategies.
Area of Science:
- Pediatric Traumatology
- Public Health
- Epidemiology
Background:
- Anecdotal evidence suggested Hispanic children were overrepresented in burn injuries.
- A regional trauma center observed a higher incidence of scald burns from hot food among Hispanic pediatric patients.
- This study aimed to quantify injury incidence and severity differences between Hispanic and non-Hispanic white children.
Purpose of the Study:
- To compare the incidence and severity of traumatic injuries in Hispanic versus non-Hispanic white children in Washington State.
- To identify specific injury mechanisms disproportionately affecting Hispanic pediatric populations.
- To inform targeted injury prevention efforts.
Main Methods:
- Utilized data from the Washington State Trauma Registry (1995-1997) for individuals aged 19 years and younger.
- Calculated incidence rate ratios (RR) comparing Hispanic to non-Hispanic white children using U.S. Census Bureau population data.
- Compared injury severity measures, including mortality and length of hospital stay.
Main Results:
- Overall traumatic injury incidence rates were similar between Hispanic (54/100,000) and non-Hispanic white children (56/100,000), RR=1.0 (95% CI 0.8, 1.1).
- Hispanic children had significantly higher injury rates for burns (RR=2.3), guns (RR=2.2), and cuts/piercings (RR=3.5).
- Hispanic children had lower rates of motor vehicle crash injuries (RR=0.7), with similar mortality rates and shorter hospital stays.
Conclusions:
- No significant difference in the overall burden of traumatic pediatric injury between Hispanic and non-Hispanic white children.
- Burns, gun-related injuries, drowning, and penetrating trauma are disproportionately significant for Hispanic children.
- Further research into specific injury types is crucial for identifying and addressing preventable risk factors.
Objectives:
The authors' anecdotal experience at a regional Level I trauma center was that Hispanic children were overrepresented among burn patients, particularly among children with burns due to scalding from hot food. This study describes injury incidence and severity among Hispanic and non-Hispanic white infants, children, and adolescents with serious traumatic injuries in Washington State.
Methods:
Data from the Washington State Trauma Registry for 1995-1997 were used to identify injured individuals aged < or = 19 years. Ratios of overall and mechanism-specific injury incidence rates for Hispanic children relative to non-Hispanic white children were calculated using denominator estimates derived from U.S. Census Bureau population data. Hispanic children and non-Hispanic white children were also compared on several measures of severity of injury.
Results:
In 1995-1997, serious traumatic injuries were reported to the Registry for 231 Hispanic children aged < or = 19 years (rate: 54 per 100,000 person-years) and for 2,123 non-Hispanic white children (56 per 100,000 person-years), yielding an overall rate ratio (RR) of 1.0 (95% confidence interval [CI] 0.8, 1.1). Motor vehicle crashes and falls accounted for one-third to one-half of the injuries for each group. Infants, children, and adolescents identified as Hispanic had higher rates of injuries related to hot objects (i.e., burns) (RR=2.3; 95% CI 1.3, 4.1), guns (RR=2.2; 95% CI 1.5 to 3.3), and being cut or pierced (RR=3.5; 95% CI 2.2 to 5.5). The Hispanic group had a lower injury rate for motor vehicle accidents (RR=0.7; 95% CI 0.5, 0.9). Mortality rates were similar (RR=1.1; 95% CI 0.7, 1.7). The mean length of hospital stay was 5.5 days for the Hispanic group and 8.8 days for the non-Hispanic white group (difference=3.3 days; 95% CI -0.7, 7.4).
Conclusions:
The study found little difference between Hispanic and non-Hispanic white infants, children, and adolescents in the burden of traumatic pediatric injury. However, burns, guns, drowning, and being pierced/cut appeared to be particularly important mechanisms of injury for Hispanic children. More specific investigations targeted toward these injury types are needed to identify the underlying preventable risk factors involved.
