Rausch, T. K., Sanddal, N. D., Sanddal, T. L., & Esposito, T. J.
(1998) Changing Epidemiology of injury-related pediatric mortality in a
rural state: Implications for injury control. Pediatric Emergency
Care, 14(6), 388-92.
OBJECTIVE: To document current epidemiology of pediatric
injury-related deaths in a rural state and evaluate changes over time.
METHODS: Retrospective review of injury-related deaths in
children < 15 occurring in Montana, 1989-1992. Data were obtained
from death certificates, coroner, autopsy, prehospital and hospital
records. Analysis of mechanism of injury, age, gender, race, location of
incident, toxicology, and safety device use. Comparison was made to
analogous data collected from an earlier time period.
RESULTS: Of 121 cases reviewed, 56% were male, 44% female; mean age
was 7.0 years: 81% Caucasian, 16% Native American. Leading cause of
injury was motor vehicle crashes, followed by drowning, unintentional
firearm injuries, deaths related to house fires, homicides, and
suicides. Overall, 87% of injuries were unintentional: 13% were
intentional, with 62% of these suicides and 38% homicides. When
considered independently of intent, firearm-related injuries ranked
second. Comparison of deaths, unintentional firearm injury deaths, and
deaths of motor vehicle occupants.
CONCLUSION: The epidemiology of rural pediatric injury-related deaths
has changed. Violent deaths related to injuries caused by firearms are
at a magnitude approaching all other causes. These finding have
implications for injury control strategies in rural areas.