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Published on: August 25, 2014
The epidemiology of infant injuries and alarming health disparities
Richard A Falcone1, Rebeccah L Brown, Victor F Garcia
1Division of Pediatric and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA. richard.falcone@cchmc.org
Insights
African-American infants face a 3.5 times higher risk of preventable injury deaths than white infants. This disparity in infant mortality, particularly from abuse and suffocation, persists regardless of health insurance status.
Area of Science:
- Public Health
- Epidemiology
- Injury Prevention
Background:
- Injury epidemiology is crucial for effective prevention strategies.
- Significant disparities exist in infant injury-related mortality between African Americans and white populations.
Purpose of the Study:
- To investigate the epidemiology of infant injury-related mortality rates.
- To understand racial disparities in infant mortality.
Main Methods:
- Reviewed trauma database for infant injuries over a 10-year period (1995-2004).
- Analyzed mortality rates based on race, injury mechanism, and health insurance type.
Main Results:
- Identified 1270 infant injuries; 4.8% overall mortality.
- African-American infants had significantly higher mortality rates for overall injury (9.6% vs 2.8%), abuse (15% vs 4%), and suffocation (100% vs 55%).
- Mortality disparities persisted between races even when controlling for health insurance type.
Conclusions:
- African-American infants have a 3.5 times increased risk of death from preventable injuries compared to white infants.
- This disparity is not explained by socioeconomic status (indicated by insurance type).
- Targeted injury prevention programs addressing abuse and suffocation among African-American infants are critical.
Purpose:
Injury epidemiology is the underappreciated foundation of injury prevention and control strategies. Given the substantial disparity of infant injury-related mortality between African Americans (AA) and whites in our region, we sought to better understand the epidemiology of infant injury-related mortality rates.
Methods:
Our trauma database was reviewed for all infant injuries over a 10-year period. The mortality rates were analyzed based on race, mechanism, and health insurance type.
Results:
From 1995 to 2004, 1270 infants were identified. Sixty-nine percent were white, 26% AA, and 5% were other. Overall mortality was 4.8%. There were significant disparities in mortality comparing AA to whites: overall, 9.6% vs 2.8%*; abuse, 15% vs 4%*; suffocation, 100% vs 55%* (*P < .05). Although 75% of AA vs 40% of whites were insured by Medicaid, when separated by insurance type, the disparity in mortality rates between races remained significant.
Conclusions:
African-American infants have 3.5 times increased risk of death from preventable injuries compared to white infants. This disparity persists despite controlling for type of health insurance, a surrogate for socioeconomic status. Understanding these disparities and developing injury-prevention programs targeting high-risk mechanisms of injury such as abuse and suffocation among AA is critical toward eventually eliminating these preventable deaths.
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