Violent death in the pediatric age group: rural and urban differences.

Violent death (homicide and suicide) in the pediatric age group is a major public health problem. A descriptive study was undertaken to review retrospectively the 1077 pediatric coroner's cases in 11 California counties for differences between urban and rural violent death rates. Pediatric violent death was more prevalent in the urban region than in the rural region (P less than 0.0007). High urban homicide rates accounted for most of this difference. Suicide rates were not significantly different (P = 0.18). Seventy-four percent of the violent deaths were in the 15- to 18-year age group, and most of these deaths were caused by firearms (81%). Blacks had the highest homicide and suicide rates. Child abuse was an important cause of death for young children in the urban area only. Socioeconomic factors, cultural differences, high population density, and the availability of firearms were proposed as factors affecting violent death in the pediatric age group.