Department of Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
J Trauma Acute Care Surg. 2012 Oct;73(4):1006-10. doi: 10.1097/TA.0b013e318265d10a.
Unintentional injuries are one of the leading causes of death in the United States. Many of these injuries are preventable, and unintentional firearm injuries, in particular, may be responsive to prevention efforts. We investigated the relationship between unintentional firearm death and urbanicity among adults.
This study was a retrospective analysis of national death certificate data. Unintentional adult firearm deaths in the United States from 1999 to 2006 were identified using the Multiple Cause of Death Data files from the National Center for Health Statistics. Decedents were assigned to a county of death and classified along an urban-rural continuum defined by population density and proximity to metropolitan areas. Total unintentional firearm death rates by county were analyzed in adjusted analyses using negative binomial regression.
A total of 4,595 unintentional firearm injury deaths of adults occurred in the United States during the study period (a mean of 574.4 per year). Adjusted rates of unintentional firearm death showed increases from urban to rural counties. Americans in the most rural counties were significantly more likely to die of unintentional firearm deaths than those in the most urban counties (relative rate, 2.16; 95% confidence interval, 1.44-3.21, p = 0.002).
Rates of unintentional firearm death are significantly higher in rural counties than in urban counties. Prevention strategies should be tailored to account for both geographic location and manner of firearm injury.
Epidemiologic study, level III.
在美国，意外伤害是导致死亡的主要原因之一。其中许多伤害是可以预防的，特别是意外伤害枪支，可能对预防措施有反应。我们研究了成年人意外伤害枪支死亡与城市性之间的关系。
本研究是对国家死亡证明数据的回顾性分析。使用国家卫生统计中心多病因死亡数据文件，在美国 1999 年至 2006 年期间确定了成人意外伤害枪支死亡。死者被分配到死亡的县，并根据人口密度和靠近大都市区的程度沿城乡连续体进行分类。使用负二项回归对调整后的分析中的每个县的总意外伤害枪支死亡率进行分析。
在研究期间，美国共有 4595 例成人意外伤害枪支伤害死亡（平均每年 574.4 例）。调整后的意外伤害枪支死亡率显示，从城市到农村县呈上升趋势。美国最农村县的人死于意外伤害枪支的可能性明显高于最城市县的人（相对比率，2.16；95%置信区间，1.44-3.21，p = 0.002）。
农村县意外伤害枪支死亡的发生率明显高于城市县。预防策略应根据地理位置和枪支伤害方式进行调整。
流行病学研究，III 级。
