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Journal Article

Citation

Williams BC, Kotch JB. Pediatrics 1990; 86(6 Pt 2): 1067-1073.

Affiliation

Department of Maternal and Child Health, University of North Carolina School of Public Health, Chapel Hill.

Copyright

(Copyright © 1990, American Academy of Pediatrics)

DOI

unavailable

PMID

2243742

Abstract

Using data from the National Center for Health Statistics and the World Health Organization, child injury death rates in the US were compared to those of Canada, England and Wales, France, Netherlands, and Norway. Except for the 1981 Canadian figure, overall US childhood injury mortality was greater than childhood injury mortality rates of all countries studied during each year from 1980 to 1986. Injury mortality steadily declined in most other countries, whereas the US rate appears to be increasing. Attention to specific causes reveals that much of the difference is explained by motor vehicle injuries and homicide, but in every childhood age group US death rates due to drowning, firearms, homicide, poisoning, and fire are among the highest. Excess US injury mortality is largely attributable to deaths among children younger than 5 and older than 14 years of age, the most vulnerable groups in all countries. Especially high rates among US minorities account for little of the observed differences; for many injuries, the mortality rate of US nonblacks is several times those reported by the comparison nations. Behavioral strategies are inadequate to deal with excess death rates of this magnitude. Limiting exposure through regulation of handguns, greater use of public transportation, and affordable and accessible day care are among the measures that should be implemented.

VioLit summary:

OBJECTIVE:
In order to show statistics and trends, this study by Williams and Kotch provided a comparison of U.S. child injury mortality by cause and age group with available data from Canada, England and Wales, France, the Netherlands, and Norway.

METHODOLOGY:
This study was a comparative review of the literature. Data were derived from special tabulations provided by the World Health Organization (WHO) and from vital statistics published by the National Center for Health Statistics (NCHS). WHO used basic tabulation lists of external cause of injury codes (E-codes). NCHS statistic databases varied slightly from those of WHO, but were comparable and both covered the period 1980 to 1986.

FINDINGS/DISCUSSION:
Except for the 1981 Canadian figure, overall U.S. childhood injury mortality rates were greater than childhood injury rates in all countries studied during each year from 1980 to 1986. Injury mortality rates steadily declined in most other countries, whereas the U.S. rate appeared to be on the increase. Specific causes revealed that of the difference between the U.S. and other countries was explained by motor vehicle injuries and homicide, but in each childhood age group U.S. death rates due to drowning, firearms, homicide, poisoning, and fire were among the highest.
Excess U.S. injury mortality was largely attributable to deaths among children younger than 5 and older than 14 years of age, the most vulnerable age groups for all countries. High rates among U..S minorities accounted for little of the observed differences. For many injuries, the mortality rate of U.S. nonblacks was several times higher than those reported by the comparison countries. Noteworthy was that motor vehicle injuries accounted for a large share of the gap between the U.S. and other nations. Also, homicide in the U.S. was substantially more common than in the comparison countries in all age groups.
Behavioral strategies (to modify behavior patterns among youth) have been inadequate to deal with the excess death rates experienced in the U.S.

AUTHORS' RECOMMENDATIONS:
It was noted was that in an ideal situation efforts to reduce risk of injury, death, and acquired disability in early life should include a wide range of supports to parents and families. The authors recommended emulating the European examples which provided routine home visits by public health nurses; subsidized preventive care for all children; accessible, affordable, high quality child care; inexpensive and widely available public transportation, and family allowances to partially offset the expense of rearing children. Also recommended were additional restrictions of children's access to guns, cars, alcohol, and drugs.

(CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado)

KW - US-Foreign Comparison
KW - Cross-National Comparison
KW - Canada
KW - England
KW - Wales
KW - France
KW - Netherlands
KW - Norway
KW - Comparative Analysis
KW - Death Rates
KW - Countries Other Than USA
KW - Child Victim
KW - Child Injury
KW - Juvenile Injury
KW - Juvenile Victim
KW - Injury Rates
KW - Injury Incidence and Prevalence
KW - Injury Victim
KW - Victimization Rates
KW - Victimization Incidence and Prevalence
KW - Accidental Death
KW - Homicide Incidence and Prevalence
KW - Homicide Rates
KW - Homicide Victim
KW - Firearms Violence
KW - Statistical Data


Language: en

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