Injury fatalities among young children.

Injuries and violence are the primary causes of death among young children in the United States. In particular, in 1982-84 motor vehicle injuries, fires, drowning, and homicide were the leading external causes of death at ages 1-4 years and 5-9 years, accounting for nearly 80 percent of all deaths from external causes. The purpose of this article is to analyze race and sex differentials in injury fatalities among young children. Race and sex differentials in injury mortality were measured in terms of relative risks, that is, race (black to white) and sex (male to female) mortality ratios. Race ratios for external causes ranged from 1.7 to 1.9 for children 1-4 and 5-9, while sex ratios were somewhat lower, 1.4 to 1.8. Although race and sex ratios were relatively small for passenger-related motor vehicle fatalities (0.8 to 1.2) the ratios for pedestrian-related injuries were considerably greater (1.5 to 2.0). Race ratios for deaths caused by fires and homicide were particularly large (3.4 to 4.3). Mortality differences were also measured in terms of excess mortality. For each age-race group more than 65 percent of the overall excess deaths among males were due to external causes of death. Pedestrian-related motor vehicle injuries and drownings accounted for the largest proportion of excess deaths among males. At ages 1-4, 53 percent of the overall excess deaths among blacks were due to external causes. Deaths caused by fires and homicide accounted for more than two-fifths of the excess in this age group. At ages 5-9, 81 percent of excess mortality among black males and 69 percent among black females were accounted for by external causes. Fires, pedestrian-related motor vehicle fatalities, and homicides accounted for nearly 65 percent of excess mortality among black children.There has been a 30 percent decline in death rates from all external causes between 1972-74 and 1982-84. Pedestrian-related motor vehicle death rates declined the most in both age groups.Mortality also declined in each age-race-sex group for passenger-related motor vehicle injuries, for drownings, and for fires except among black males ages 5-9. Homicide, in contrast, increased in both age groups. There has been little change, however,in the incidence of injuries among children. Thus,it appears that declines in fatalities accounted for a major portion of the mortality reduction.