Nonnatural deaths of adolescents and teenagers: Fulton County, Georgia, 1985-2004.
BACKGROUND
Childhood deaths are carefully scrutinized by many different government agencies, fatality review panels, researchers, and other groups. Many such deaths, especially those that involve external causes such as injury and poisoning, are amenable to prevention. Characterizing the causes and circumstances of nonnatural childhood deaths may provide information that is useful for development of prevention strategies and programs.


METHODS
This is a retrospective review of all nonnatural deaths investigated and certified by the Fulton County Medical Examiner involving persons 10 to 19 years of age during the years 1985-2004, inclusive. Cases were identified by searching electronic death investigation files maintained during the study period. Demographic and circumstantial information were tabulated for homicides, suicides, motor-vehicle fatalities, and other accidental deaths, and crude death rates were calculated for each 5-year period during the study.


RESULTS
During the 20 year period there were 961 nonnatural deaths among persons 10 to 19 years of age. Most deaths were due to homicide (48%) followed by motor-vehicle fatalities (30%), suicide (12%), and nontraffic accidental fatalities (10%). Black males had the highest death rates among the homicide, suicide, and nontraffic accidental deaths, although the rates for each of these were lower in the most recent 5 year period than the first 5-year period. The number of deaths increased in each category as age increased, and this observation was most marked for homicides and least marked for nontraffic accidental deaths. Firearms were involved in 88% of homicides and 61% of suicides. Most nontraffic accidental deaths were due to water-related accidents, followed by drug and/or alcohol toxicity, fire-related injuries, and accidental firearms injuries.


CONCLUSIONS
Homicide accounts for almost half of all deaths among persons 10 to 19 years of age. Black males are at particularly high risk for nonnatural death in comparison with other race/sex groups, especially for homicide. If effective firearm fatality prevention strategies and programs could be implemented, data in this study suggests that such a measure alone could cut in half the nonnatural mortality rate in the 10 to 19 year age group in Fulton County. Although homicide and suicide rates have declined, there remains room for improvement in these areas, as is the case for traffic-related and other accidental fatalities.
Heninger
Michael
M
Fulton County Medical Examiner's Center; and daggerEmory University School of Medicine, Atlanta, GA, USA. michael.heninger@co.fulton.ga.us
Hanzlick
Randy
R
D000059:Accidents / Q000401:mortality; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002423:Cause of Death / Q000639:trends*; D002648:Child; D003334:Coroners and Medical Examiners; D004332:Drowning / Q000401:mortality; D005260:Female; D005390:Fires; D005554:Forensic Medicine; D005845:Georgia / Q000453:epidemiology; D006708:Homicide / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008722:Methods; D011041:Poisoning / Q000401:mortality; D044469:Racial Groups / Q000706:statistics & numerical data; D012189:Retrospective Studies; D017678:Sex Distribution; D013405:Suicide / Q000706:statistics & numerical data; D014948:Wounds, Gunshot / Q000401:mortality