The 130th Annual Meeting of APHA

Abstract #48589

Edmond Shenassa, ScD, Department of Community Health, Brown Medical School, 164 Summit Ave., Providence, RI 02906, 401-793-8120, Edmond_Shenassa@brown.edu, Amy Stubbendick, Biostatistics, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115, and Mary Jean Brown, RN, ScD, Department of Maternal and Child Health, Harvard School of Public Health, 677 Huntington Av., Boston, MA 02115.

This population-based multi-level study examined non-fatal pediatric injuries that occurred at home and required hospitalization. We examined the hypothesis that a community's proportion of owner occupancy and old housing mediate the effect of poverty and race. Individual-level information, including ZIP code, age and gender, was collected for children £ 6 years old living in Illinois from 1990-2000 and was linked to the 1990 US census. Of the 11,867 hospital discharges, 43% were falls and 15% were burns. Of those children burned, 58% were between 1 and 2 years old. For falls, the age distribution was more even. Males were more likely to be injured. In ZIP code level analyses, an increase in poverty, old housing and the proportion of African American residents increased the risk of an injury. Increasing owner occupancy decreased the risk of injury. Owner occupancy was also found to be a mediator in the relationship between poverty and the risk of a fall. For burns, both owner occupancy and race had a significant interaction with poverty. Controlling for individual-level risks did not meaningfully change community-level risks of falls and burns. This study suggests that community-level risks for pediatric burns and falls operate independently of individual-level risks. We also found that the effect of poverty is modified by social-structural factors, in particular owner occupancy and age of housing. These findings can help public health programs target interventions to areas where the need is greatest.

Learning Objectives:

• Identify individual level factors that put children at risk for serious burn or fall injuries.
• Identify community level risk factors for these injuries.
• Use community level risk factors to target intervention strategies.

Presenting author's disclosure statement:
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.