Mull D S, Agran P F, Winn D G, Anderson C L
Pediatric Injury Prevention Research Group, Center for Health Policy and Research, University of California, Irvine 92697-5800, USA.
Soc Sci Med. 2001 Apr;52(7):1081-91. doi: 10.1016/s0277-9536(00)00215-x.
Several studies indicate that rates of serious pediatric injury are higher among Hispanics than among non-Hispanic whites in the USA. To investigate possible contributory factors, we interviewed 50 Mexican, 30 Mexican American, and 30 non-Hispanic white mothers in their own homes in the same low-income neighborhoods of Southern California. Mothers were identified via door-to-door canvassing in areas with high rates of pediatric injury. We observed household conditions and behaviors and obtained a detailed family history, including accounts of any occurrence of serious injury in a child under 5 years old, the highest-risk age group for pediatric injury. Results show that Mexican families were poorer, less educated, and lived in more hazardous and crowded conditions than did families in the other two groups. Nevertheless, they benefited from strong family bonds and a cultural tradition in which responsible older children typically supervise younger siblings. In contrast, a number of Mexican American and white mothers had been abused as children and were estranged from their own mothers; hence they lacked support and models of good parenting. There was much less self-reported smoking, drug use, and mental dysfunction among the Mexican mothers and their male partners as well as much less excessively active and/or aggressive behavior among their children. The nature of the injuries reported by the various groups seemed to reflect these differences. Appropriate interventions for each group are discussed. The study illustrates the importance of using ethnographic methods to examine the context of pediatric injury at the household level.
多项研究表明，在美国，西班牙裔儿童遭受严重伤害的比率高于非西班牙裔白人儿童。为了调查可能的促成因素，我们在南加州同一低收入社区的家中，对50名墨西哥母亲、30名墨西哥裔美国母亲和30名非西班牙裔白人母亲进行了访谈。通过在儿童伤害发生率高的地区挨家挨户拉票来确定母亲们。我们观察了家庭环境和行为，并获取了详细的家族病史，包括5岁以下儿童（儿童伤害的最高风险年龄组）中任何严重伤害事件的记录。结果显示，与其他两组家庭相比，墨西哥家庭更贫困、受教育程度更低，居住环境更危险、更拥挤。然而，他们受益于牢固的家庭纽带和一种文化传统，在这种传统中，有责任感的年长儿童通常会照看年幼的兄弟姐妹。相比之下，一些墨西哥裔美国母亲和白人母亲在童年时曾遭受虐待，与自己的母亲关系疏远；因此，她们缺乏支持和良好育儿的榜样。墨西哥母亲及其男性伴侣自我报告的吸烟、吸毒和精神功能障碍情况要少得多，她们孩子过度活跃和/或攻击性行为的情况也少得多。不同群体报告的伤害性质似乎反映了这些差异。文中讨论了针对每个群体的适当干预措施。该研究说明了使用人种学方法在家庭层面检查儿童伤害背景的重要性。
