Analysis of injury- and violence-related fatalities in the Ohio Medicaid population: identifying opportunities for prevention.
BACKGROUND
To identify the leading causes of injury- and violence-related deaths in demographic subgroups of the population in Ohio, by Medicaid status.


METHODS
We used linked Ohio Medicaid and death certificate files, 1992 to 1998, and obtained the probability (p) of dying from a specific mechanism of injury--given death from injury--by Medicaid status, using multinomial multivariable logistic regression analysis. Probabilities were rank-ordered to identify the leading causes of death in each subgroup.


RESULTS
The leading cause of injury-related deaths was homicide among Medicaid decedents in the age groups 0 to 4, 15 to 24, and 25 to 44 (p = 0.283, 0.380, and 0.269, respectively), and motor vehicle crashes among nonMedicaid decedents aged 5 to 14, 15 to 24, 25 to 44, and 45 to 74 (p = 0.448, 0.462, 0.293, and 0.293, respectively). Accidental falls ranked first among the elderly (p = 0.593 and 0.414, respectively in Medicaid and nonMedicaid decedents). Suicide and accidental exposure to smoke, fire, and flames also ranked high among the leading causes of injury-related deaths in many population subgroups.


CONCLUSIONS
Findings from this study, pointing to the vulnerability of population subgroups to certain mechanisms of injury, can be used to formulate targeted prevention strategies.
Koroukian
Siran M
SM
Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Ohio 44106-4945, USA. skoroukian@case.edu
Beaird
Heather
H
Duldner
John E
JE
Diaz
Mireya
M
D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000401:mortality; D000293:Adolescent; D000328:Adult; D000368:Aged; D002056:Burns / Q000401:mortality; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003644:Death Certificates; D006708:Homicide / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008484:Medicaid / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D009820:Ohio / Q000453:epidemiology; D012189:Retrospective Studies; D013405:Suicide / Q000706:statistics & numerical data; D014754:Violence; D014947:Wounds and Injuries / Q000401:mortality* / Q000517:prevention & control