Injuries to children in a Native American community

The rate of hospitalization of children with injuries in one service unit was three times that of the Albuquerque Area Indian Health Service as a whole. To determine the reasons, mortality and hospitalization data were analyzed and an indepth review of medical records was performed. Among the possible explanations for the high injury rate that were excluded were an artifact of reporting, uncertain denominator data, lack of age-adjustment, lower socioeconomic status of the community, differential thresholds for hospitalization, and an increase in a few specific types of injury. Alternative hypotheses involve life-style issues and psychosocial stress. These hypotheses are supported by data concerning alcohol abuse and foster care and have profound implications for injury control efforts in this community.