The epidemiology of infant injuries and alarming health disparities.
OBJECTIVE
Injury epidemiology is the underappreciated foundation of injury prevention and control strategies. Given the substantial disparity of infant injury-related mortality between African Americans (AA) and whites in our region, we sought to better understand the epidemiology of infant injury-related mortality rates.


METHODS
Our trauma database was reviewed for all infant injuries over a 10-year period. The mortality rates were analyzed based on race, mechanism, and health insurance type.


RESULTS
From 1995 to 2004, 1270 infants were identified. Sixty-nine percent were white, 26% AA, and 5% were other. Overall mortality was 4.8%. There were significant disparities in mortality comparing AA to whites: overall, 9.6% vs 2.8%*; abuse, 15% vs 4%*; suffocation, 100% vs 55%* (*P < .05). Although 75% of AA vs 40% of whites were insured by Medicaid, when separated by insurance type, the disparity in mortality rates between races remained significant.


CONCLUSIONS
African-American infants have 3.5 times increased risk of death from preventable injuries compared to white infants. This disparity persists despite controlling for type of health insurance, a surrogate for socioeconomic status. Understanding these disparities and developing injury-prevention programs targeting high-risk mechanisms of injury such as abuse and suffocation among AA is critical toward eventually eliminating these preventable deaths.
Falcone
Richard A
RA
Division of Pediatric and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA. richard.falcone@cchmc.org
Brown
Rebeccah L
RL
Garcia
Victor F
VF
D001741:Black or African American / Q000706:statistics & numerical data*; D001237:Asphyxia / Q000191:economics / Q000401:mortality; D002649:Child Abuse / Q000191:economics / Q000401:mortality; D005260:Female; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends; D007231:Infant, Newborn; D007350:Insurance, Hospitalization / Q000145:classification; D008297:Male; D008484:Medicaid; D009820:Ohio / Q000453:epidemiology; D018570:Risk Assessment; D012923:Social Class; D012959:Socioeconomic Factors; D014193:Trauma Centers / Q000706:statistics & numerical data*; D035862:Vulnerable Populations; D044465:White People / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000145:classification / Q000191:economics / Q000208:ethnology* / Q000401:mortality*