Department of Biostatistics, Columbia University, 722 West 168th Street, New York, NY 10032, USA.
Department of Epidemiology, Columbia University, 722 West 168th Street, New York, NY 10032, USA.
Int J Environ Res Public Health. 2017 Oct 25;14(11):1287. doi: 10.3390/ijerph14111287.
There are large disparities in American Indian pediatric motor vehicle (MV) mortality with reports that several factors may contribute. The Fatality Analysis Reporting System for 2000-2014 was used to examine restraint use for occupants aged 0-19 years involved in fatal MV crashes on Indian lands ( = 1667) and non-Indian lands in adjacent states ( = 126,080). SAS GLIMMIX logistic regression with random effects was used to generate odds ratios (OR) with 95% confidence intervals (CI). Restraint use increased in both areas over the study period with restraint use on Indian lands being just over half that of non-Indian lands for drivers (36.8% vs. 67.8%, < 0.0001) and for pediatric passengers (33.1% vs. 59.3%, < 0.0001). Driver restraint was the strongest predictor of passenger restraint on both Indian and non-Indian lands exerting a stronger effect in ages 13-19 than in 0-12 year olds. Valid licensed driver was a significant predictor of restraint use in ages 0-12 years. Passengers in non-cars (SUVs, vans and pickup trucks) were less likely to be restrained. Restraint use improved over the study period in both areas, but disparities failed to narrow as restraint use remains lower and driver, vehicle and crash risk factors higher for MV mortality on Indian lands.
美国印第安人儿童机动车（MV）死亡率存在较大差异，有报道称有几个因素可能导致这种差异。本研究使用 2000 年至 2014 年的死亡分析报告系统（Fatality Analysis Reporting System），对印第安人土地（ = 1667）和毗邻州非印第安人土地（ = 126,080）上涉及致命 MV 碰撞的 0-19 岁乘员的约束装置使用情况进行了检查。使用 SAS GLIMMIX 对数回归模型（logistic regression）与随机效应，生成了 95%置信区间（CI）的比值比（OR）。在研究期间，两个地区的约束装置使用情况均有所增加，印第安人土地上的约束装置使用率仅为非印第安人土地的一半左右，其中包括驾驶员（36.8%比 67.8%，<0.0001）和儿童乘客（33.1%比 59.3%，<0.0001）。驾驶员约束装置是乘客约束装置的最强预测因素，在 13-19 岁年龄组的影响大于 0-12 岁年龄组。在 0-12 岁年龄组中，有效持牌驾驶员是约束装置使用的重要预测因素。非汽车（SUV、厢式货车和皮卡）中的乘客约束装置使用率较低。在研究期间，两个地区的约束装置使用情况都有所改善，但由于 MV 死亡率在印第安人土地上的约束装置使用率较低，驾驶员、车辆和碰撞风险因素较高，差距并未缩小。
