5195.0: Wednesday, November 15, 2000 - 3:00 PM

Abstract #12908

Geographic Disparities in Injury Burden among California Children, Adolescents, and Young Adults Age 0-24: The Injury Hot Spots Project

Linda Remy, PhD, Geraldine Oliva, MD, MPH, and Ted Clay, MS. Family Health Outcomes Project, Dept. of Family and Community Medicine, University of California, San Francisco, 3333 California Street, Suite 365, San Francisco, CA 94109, 415-383-5892, lremy@itsa.ucsf.edu

Among California residents age 0 to 24, injuries cause more deaths than all other causes. After excluding delivery and mental illness, injuries are the second leading cause of hospital admission. To develop effective prevention strategies, it is critical to understand injury patterns. OBJECTIVES: To identify ZIP codes with the highest injury burden overall and by intent, to produce ZIP-level maps to target injury prevention efforts, and to describe the course of treatment for injury patients. METHODS: Hospital discharge and Vital Statistics death files for 1995-1997 were searched to identify all injured California residents age 0-24 who were hospitalized or died. Records were linked to create a "person-level" file, using the last injury episode in the study period. This was summarized and rates per 100,000 population were calculated. A composite score to indicate injury burden was created based on ZIP-level quartiles of rates and numbers for total, unintentional, and intentional injuries. ZIP-level maps were created. RESULTS: We identified 150,552 injuries, or 418/100,000 with 25% intentional. The linkage permitted a better understanding of the full course of care for injury. Average days in hospital for an injury was about 5 days. Mortality was 7.5%, including 5.8% out-of-hospital deaths. Of 1,591 ZIPs, 127 were "hot", 213 "moderately hot", and 117 "warm" for total injuries. These ZIPs had 63.2% of injuries, and 28.7% of population age 0 to 24 lived there. "Hot" spots tended to cluster. CONCLUSIONS: Small area techniques help identify high-risk sub-populations and injury clusters and allow cost-effective targeting of prevention efforts.

Learning Objectives: 1. Understand the rationale for linking injury data and summarizing to the ZIP-level as a tool for planning and evaluating prevention efforts. 2. Describe injuries and the course of treatment for California residents age 0 to 24 years between 1995 and 1997. 3.Describe the impact of managed care on hospital-based treatment of injured children, adolescents, and young adults. 4. Discuss the utility of the composite score for planning and evaluating prevention efforts

Keywords: Injury Prevention, Child/Adolescent

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA