Prevention of traumatic deaths to children in the United States: how far have we come and where do we need to go?
OBJECTIVE
To describe the changes in injury mortality from 1978 to 1991 and determine the number of preventable deaths with currently available intervention strategies.


METHODS
Comparison of injury mortality data for children and adolescents 0 to 19 years in 1978 and 1991. Review of the literature to determine the effectiveness of currently available prevention strategies and application of these to deaths in 1991.


RESULTS
The injury death rate declined by 26% over the 14-year period. Death rates of unintentional injuries decreased by 39%, with declines in all categories of unintentional injuries. Homicides increased by 67% and suicides by 17%; nearly all of this increase was in deaths from firearms. If currently available prevention strategies were fully used, 6640 deaths could have been prevented, a further 31% decrease.


CONCLUSIONS
Although great studies have been made in preventing deaths from trauma, the application of currently available prevention strategies could save a large number of additional lives. However, the increasing problem of intentional injury will partly counterbalance the success in unintentional injury control.
Rivara
F P
FP
Harborview Injury Prevention and Research Center, Seattle 98104, USA.
Grossman
D C
DC
D000293:Adolescent; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D009017:Morbidity; D011159:Population Surveillance; D011322:Primary Prevention / Q000379:methods* / Q000592:standards; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000209:etiology / Q000401:mortality* / Q000517:prevention & control*