Joyce C. Pressley, PhD, MPH, Center for the Health of Urban Minorities and the Departments of Health Policy and Management and Epidemiology, Columbia University, 722 W. 168th Street, Room 17-12, New York, NY 10032, 212-342-0421, jp376@columbia.edu and Barbara Barlow, MD, College of Physicians and Surgeons, Department of Epidemiology, Harlem Hospital, and the Injury Free Coalition for Kids, Columbia University, 722 W. 168th Street, Room 17-08, New York, NY 10032.

Background. The relative lifetime contribution of injury to ethnic differences in population level health is underappreciated, but full recognition is essential for elimination of injury-related health disparities.

Methods. To quantify cumulative disparities in mechanism specific injury across the age span for American Indians/Alaska Natives (AI/AN), Blacks, Hispanics, and Asians/Pacific Islanders (AS/PI) relative to non-Hispanic whites, age-specific mortality ratios were examined for all injury-related deaths among groups aged 0 and 84 years using data from WISQARS (2000). Total years of potential life lost before age 65 (YPLL) were examined separately for all cause and injury YPLL.

Results. AI/AN and blacks had higher all cause age-specific injury mortality than whites from birth until age 75 and 80 years respectively when white rates crossed over and exceeded the two minority groups. Hispanic mortality closely paralleled whites until age 75. AS/PI had lower mortality at all ages. Mortality varied by intentionality and mechanism across age and race/ethnic groups. Injury YPLL constituted more than one fourth of total YPLL, but varied by ethnicity and mechanism: AI/AN (42.0%); Hispanics (33.8%); whites (29.0%); AS/PI (26.4%); blacks (24.4%). In particular, firearm injury accounted for 6.6% total YPLL with higher losses among all minority groups.

Conclusion. Disparities in injury mortality exhibit a cumulative effect across the age span with higher AI/AN and black rates relative to whites from birth until a mortality crossover occurs in the elderly. YPLL is useful for understanding comparative contributions of injury mechanisms, although excess rates of competing illnesses may partially mask disparities.

Learning Objectives: Attendees of this session will be able to

• Define what is meant by and how injury contributes to cumulative disadvantage across the age span
• Identify critical problem areas that must be addressed in efforts to reduce or eliminate race/ethnic/socioeconomic injury-related disparities
• Discuss ways in which the physical and social environments contribute to injury related health disparities across the age span

Keywords: Health Disparities, Injuries

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.