Bernard Stephanie J, Paulozzi Leonard J, Wallace David L J
Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia 30333, USA.
MMWR Surveill Summ. 2007 May 18;56(5):1-16.
PROBLEM/CONDITION: In the United States, unintentional injury, homicide, and suicide are the first, second, and fourth leading causes of death among persons aged 1-19 years, respectively; the highest rates have occurred among minority populations. The effects of age on the difference in rates between white and minority children and the mechanisms of injury that contribute most to that difference have not been previously reported.
Data are presented for fatal injuries among children in the United States by race/ethnicity and mechanism of injury during 1999-2002. Trends in injury mortality by race/ethnicity are provided for 1982-2002.
Fatal injury data were derived from death certificates reported through CDC's National Vital Statistics System.
During 1999-2002, among infants aged <1 year, American Indian/Alaska Natives (AI/ANs) and blacks had consistently higher total injury death rates than other racial/ethnic populations. Both populations had more than twice the rate of injury death compared with white infants. Black infants had the highest rates of unintentional suffocation and homicide, whereas AI/AN infants had the highest rate of motor-vehicle (MV)-traffic death. Among children aged 1-9 years, AI/ANs and blacks had the highest injury death rates. AI/ANs aged 1-9 years had the highest rates of MV-traffic death and drowning; in contrast, blacks aged 1-9 years had the highest rates of homicide and fire/burn death. Among children aged 10-19 years, AI/ANs and blacks consistently had higher total injury death rates than whites. AI/ANs aged 10-19 years had the highest rates of suicide and MV-traffic death, and blacks aged 10-19 years had the highest rates of homicide. The disparity in injury mortality rates by race/ethnicity during 1982-1985 had not declined by 1999-2002.
Significant disparities in injury rates still exist between white and minority children. Disparities varied by age and mechanism of injury. Hispanics and Asian/Pacific Islanders consistently had lower risk, whereas AI/ANs and blacks consistently had higher risk for fatal injuries than other racial/ethnic populations.
Educational, regulatory, and environmental modification strategies (e.g., home visitation programs, safety-belt laws, and swimming pool fencing) have been developed for each type of injury for use by health-care providers and government agencies.
问题/状况：在美国，意外伤害、他杀和自杀分别是1至19岁人群中第一、第二和第四大死因；少数民族人口中的发生率最高。此前尚无关于年龄对白人儿童与少数民族儿童发生率差异的影响以及造成该差异的主要伤害机制的报道。
提供了1999 - 2002年美国按种族/族裔和伤害机制划分的儿童致命伤害数据。还提供了1982 - 2002年按种族/族裔划分的伤害死亡率趋势。
致命伤害数据源自通过疾病控制与预防中心的国家生命统计系统报告的死亡证明。
在1999 - 2002年期间，1岁以下婴儿中，美国印第安人/阿拉斯加原住民（AI/AN）和黑人的总伤害死亡率一直高于其他种族/族裔人群。这两个人群的伤害死亡率是白人婴儿的两倍多。黑人婴儿的意外窒息和他杀发生率最高，而AI/AN婴儿的机动车（MV）交通事故死亡率最高。在1至9岁儿童中，AI/AN和黑人的伤害死亡率最高。1至9岁的AI/AN机动车交通事故死亡和溺水发生率最高；相比之下，1至9岁的黑人他杀和火灾/烧伤死亡率最高。在10至19岁儿童中，AI/AN和黑人的总伤害死亡率一直高于白人。10至19岁的AI/AN自杀和机动车交通事故死亡率最高，10至19岁的黑人他杀发生率最高。1982 - 1985年至1999 - 2002年期间，不同种族/族裔的伤害死亡率差异并未缩小。
白人儿童与少数民族儿童之间在伤害发生率上仍存在显著差异。差异因年龄和伤害机制而异。西班牙裔和亚太岛民的致命伤害风险一直较低，但AI/AN和黑人的致命伤害风险一直高于其他种族/族裔人群。
针对每种伤害类型，已制定了教育、监管和环境改善策略（如家访计划、安全带法律和游泳池围栏），供医疗保健提供者和政府机构使用。
