Muelleman R L, Walker R A, Edney J A
Department of Emergency Medical Services, University of Nebraska Medical Center, Omaha.
J Trauma. 1993 Nov;35(5):717-9.
To determine the magnitude of the discrepancy in injury death rates between urban and rural counties and which types of injury deaths contribute most to this discrepancy.
A review of Nebraska death certificates over the period 1985-1989 was undertaken. Counties were divided into four groups according to population. Group I: urban counties (n = 3); group II: counties with a town of greater than 10,000 (n = 9); group III: counties with a total population of greater than 10,000 (n = 19); group IV: counties with a total population of less than 10,000 (n = 62). Age-adjusted death rates for heart disease, cancer, cerebrovascular disease, pneumonia, and injury were tabulated. Injury deaths were further categorized by intentional injury (homicide, suicide), and unintentional injury (motor vehicle-related, falls, drownings, poisoning, farm machinery-related, choking, firearms-related, fire-related and burns).
None.
Age-adjusted death rates per 100,000 population (with 95% confidence intervals) in group IV were lower than in group I for heart disease: 209 (193.9-224.1) vs. 227.4 (216.3-238.5); cancer: 135.9 (123.7-148.1) vs. 176.3 (166.6-186.0); cerebrovascular disease: 39.9 (33.3-46.5) vs. 44.6 (39.7-49.5); pneumonia: 19.6 (15.0-24.2) vs. 23.4 (19.8-27.0); and intentional injury deaths: 13.3 (9.5-17.0) vs. 15.1 (12.2-18.0). However, age-adjusted unintentional injury death rates were 54.2% higher in group IV than in group I: 42.7 (35.9-49.5) vs. 27.7 (23.8-31.6). Motor vehicle-related death rates were 93% higher: 23.3 (18.2-28.4) vs. 12.1 (9.5-14.7); and farm machinery-related deaths were 1250% higher: 2.7 (1.0-4.4) vs. 0.2 (-0.1-0.5).
Age-adjusted unintentional injury death rates are higher in the rural counties of Nebraska, even though death rates for the four other leading causes of death (heart disease, cancer, cerebral vascular disease, and pneumonia) and intentional injury are lower. Although farm machinery-related deaths have the largest percentage difference between rural and urban counties, motor vehicle-related deaths are the major contributor to the unintentional injury death rate discrepancy in rural Nebraska.
确定城乡县之间伤害死亡率差异的幅度，以及哪种类型的伤害死亡对这种差异的贡献最大。
对1985 - 1989年期间内布拉斯加州的死亡证明进行回顾。根据人口将县分为四组。第一组：城市县（n = 3）；第二组：有超过10000人口城镇的县（n = 9）；第三组：总人口超过10000的县（n = 19）；第四组：总人口少于10000的县（n = 62）。列出了心脏病、癌症、脑血管疾病、肺炎和伤害的年龄调整死亡率。伤害死亡进一步分为故意伤害（杀人、自杀）和意外伤害（与机动车相关、跌倒、溺水、中毒、与农业机械相关、窒息、与枪支相关、与火灾相关和烧伤）。
无。
每10万人口的年龄调整死亡率（95%置信区间），第四组在心脏病方面低于第一组：209（193.9 - 224.1）对227.4（216.3 - 238.5）；癌症：135.9（123.7 - 148.1）对176.3（166.6 - 186.0）；脑血管疾病：39.9（33.3 - 46.5）对44.6（39.7 - 49.5）；肺炎：19.6（15.0 - 24.2）对23.4（19.8 - 27.0）；以及故意伤害死亡：13.3（9.5 - 17.0）对15.1（12.2 - 18.0）。然而，第四组的年龄调整意外伤害死亡率比第一组高54.2%：42.7（35.9 - 49.5）对27.7（23.8 - 31.6）。与机动车相关的死亡率高93%：23.3（18.2 - 28.4）对12.1（9.5 - 14.7）；与农业机械相关的死亡高1250%：2.7（1.0 - 4.4）对0.2（ - 0.1 - 0.5）。
内布拉斯加州农村县的年龄调整意外伤害死亡率较高，尽管其他四种主要死因（心脏病、癌症、脑血管疾病和肺炎）以及故意伤害的死亡率较低。尽管与农业机械相关的死亡在城乡县之间的百分比差异最大，但与机动车相关的死亡是内布拉斯加州农村意外伤害死亡率差异的主要原因。
