McGowan Angela Kay, Crosby Alex E, La Hasbrouck Mar, Boulton Matthew L, Kanluen Sawait, Maseru Noble A W
Epidemiology Program Office, Atlanta, GA, USA.
J Natl Med Assoc. 2006 Feb;98(2):158-64.
An apparent increase in violent deaths among children and adolescents in Detroit, MI in 2002 prompted a coordinated epidemiologic investigation involving federal, state and local organizations.
A descriptive analysis of cases and violent deaths (homicide, suicide or firearm-related) among juveniles <17 years was conducted, along with a case-control study using records from the medical examiner, police, schools and social service agencies.
Twenty-nine cases were identified. Median age was 10 years (range 1 day-16 years), and 15 (52%) were male. There were 25 homicides, two suicides and two unintentional firearm-related deaths. Nine (31%) homicides resulted from child abuse and neglect, and eight (28%) were among bystanders. The most common mechanism of fatal injury was firearm (63%). Victims' families were more likely to have a history of familial violence, prior contact with the state social services agency, > or = 2 adults and > or = 4 persons in the household (P<0.05).
The 2002 deaths did not represent a statistically significant increase from previous years. Several findings were remarkable: the proportion of deaths among bystanders, females and children age <5.
2002年密歇根州底特律市儿童和青少年暴力死亡人数明显增加，促使联邦、州和地方组织开展了一项协同的流行病学调查。
对17岁以下青少年的病例和暴力死亡（凶杀、自杀或与枪支相关）进行了描述性分析，并利用法医、警方、学校和社会服务机构的记录开展了一项病例对照研究。
共确定了29例病例。中位年龄为10岁（范围1天至16岁），15例（52%）为男性。有25起凶杀案、2起自杀案和2起与枪支相关的意外死亡。9起（31%）凶杀案是由虐待和忽视儿童导致的，8起（28%）发生在旁观者身上。最常见的致命伤害机制是枪支（63%）。受害者家庭更有可能有家庭暴力史、此前与州社会服务机构有过接触、家庭中有≥2名成年人和≥4人（P<0.05）。
2002年的死亡人数与前几年相比在统计学上没有显著增加。有几个发现值得注意：旁观者、女性和5岁以下儿童的死亡比例。
