Violent injuries among adolescents: declining morbidity and mortality in an urban population.
OBJECTIVE
Adolescent homicide rates are decreasing nationally for unclear reasons. We explore changes in intentional injury morbidity and mortality within the context of other injuries and specific causes.


METHODS
We performed surveillance of hospital, medical examiner, and vital records for nonfatal injury among adolescents age 10 to 19 years living in the District of Columbia from June 15, 1996, to June 15, 1998, and fatal injury from 1989 to 1998.


RESULTS
Over the 2-year study period, 15,190 adolescents were seen for injury, resulting in an event-based rate of 148 injuries per 1,000 adolescents per year; 7% required hospitalization, and 0.8% died. Interpersonal intentional injuries accounted for 25% of all injuries, 45% of hospitalizations, and 85% of injury deaths. Assault morbidity decreased with no change noted for unintentional and self-inflicted injury. Firearm injuries, stabs, and assaults with other objects showed the largest decrease, with no decrease in unarmed assaults. Injury mortality peaked in 1993 and has declined since. Firearms caused 72% to 90% of all injury deaths from 1989 to 1998, most the result of homicide.


CONCLUSIONS
There has been a decline in intentional injury rates over the study periods related to decreased weapon injury; data suggest a change in the lethality of fighting methods but no change in unarmed fighting behavior.
Department of General Pediatrics and Adolescent Medicine, George Washington University School of Medicine and School of Public Health, USA.
T L
TL
Cheng
J L
JL
Wright
C B
CB
Fields
R A
RA
Brenner
R
R
O'donnell
D
D
Schwarz
P C
PC
Scheidt
D000293:Adolescent; D002423:Cause of Death; D002648:Child; D004219:District of Columbia; D005260:Female; D006708:Homicide / Q000639:trends*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014505:Urban Population / Q000706:statistics & numerical data*; D014754:Violence / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000401:mortality*; D014948:Wounds, Gunshot / Q000401:mortality