The studies show that residential injuries remain a leading cause of death in children and adolescents -- particularly African-American children -- and that most injuries that result in an emergency department visit occur in the home. The studies will be presented at the Pediatric Academic Societies annual meeting in Seattle.
The researchers found that:
- Between 1985 and 1997, 2,800 children and adolescents died each year as a result of unintentional injury in the home.
- Between 1993 and 1999, children under the age of 20 made 4 million visits each year to emergency departments in the United States.
- Nearly one of every 10 visits to an emergency department for a residential injury was for a moderate or severe injury.
"Children's health is inextricably linked with housing," says Bruce Lanphear, MD, director of the Children's Environmental Health Center at Cincinnati Children's. "Unfortunately, despite evidence that residential exposures have a dramatic impact on children's health, housing is largely ignored as a public health problem. Our research is aimed at making housing and the environment safe for children."
Dr. Lanphear led one of the studies, which showed that 69 percent of deaths in children and adolescents between 1985 and 1997 in the United States were the result of unintentional, residential injuries. The death rate for residential injuries was twice as high in African-American children compared to white children (7 per 100,000 population vs. 3.3 per 100,000 population).
The rate of injury was highest among children younger than 5, and boys were at higher risk than girls. Deaths were due to (in descending order) fires or burns, submersions or suffocations, poisonings, and falls. Fatal residential injuries actually declined significantly between 1985 and 1997, about 25 percent a year.
The study was the first of residential deaths in children in the United States in nearly 20 years. The researchers used data from the National Death Index.
The other study, led by Kieran J. Phelan, MD, assistant professor of pediatrics, found that residential injuries accounted for nearly 15 percent of all child and adolescent visits to the emergency department and 39 percent of unintentional injury visits between 1993 and 1999. The study revealed that falls were the leading mechanism of injury, resulting in 1.5 million visits a year. Injury rates declined during this period by 29 percent, from 6.3 per 100 in 1993 to 4.5 per 100 in 1999. Still, there were more than 78,000 hospitalizations from residential injuries each year.
Data on emergency department visits were obtained from the National Hospital Ambulatory Medical Care Survey, which was conducted by the National Center for Health Statistics. The study was supported by a grant from the US Department of Housing and Urban Development,
"These studies show that efforts to reduce the burden of injury for children and adolescents should be targeted to the home," says Dr. Phelan. "A national strategy to make housing safer for children is needed to reduce deaths from household injuries and the associated racial health disparities."