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Epidemiology of nonfatal injuries among urban and rural residents

Hope Tiesman, MSPH1, Craig Zwerling, MD, PhD, MPH2, M. Warner3, Corinne Peek-Asa, PhD2, Paul Whitten, MA2, and Nancy Sprince, MD, MPH4. (1) Department of Epidemiology, University of Iowa, 100 Oakdale Campus, Iowa City, IA 52242, 319-621-2983, hope-tiesman@uiowa.edu, (2) Injury Prevention Research Center, University of Iowa, 100 Oakdale Campus, #124 IREH, Iowa City, IA 52242, (3) National Center for Health Statistics, CDC, 6525 Belcrest Road, Hyattsville, MD 20782, (4) Department of Occupational and Environmental Health, University of Iowa, 138 IREH, 100 Oakdale Campus, Iowa City, IA 52242

It is well-established that injuries are a leading cause of mortality in the US and strong associations between injury mortality and degree of rurality have been demonstrated. However, a description of the disparities in non-fatal injury rates by rurality is currently lacking. The National Health Interview Survey (NHIS) is an ongoing, nation-wide, survey that monitors the health of the noninstitutionalized civilian population each year based on a multistage probability sampling design. Using data from the 1997-2001 NHIS, we examined nonfatal injury rates using four levels of rurality. All participants aged 18 to 65 years of age who had a non-fatal medically attended injury were selected for the analysis. Rates per 1000 persons and their associated standard errors were computed using SUDAAN. Counties were coded according to Urban Influence Codes (UIC) and were categorized into four groups; large urban, small urban, suburb with some urban influence, and rural. Preliminary data indicate that the rural counties have injury rates of 121.3, which are 27% higher than the large urban counties. Higher rural rates persisted within all income and gender categories as well as within persons of Caucasian race, younger age groups and higher education categories. Rural counties also experienced higher rates for falls and overexertion injuries as well as injuries sustained while engaged in leisure activities or work around the house. The results suggest that rural residents have uniformly higher injury rates and potentially have unique risks for injury morbidity. Understanding why these differences exist should be a priority for researchers.

Learning Objectives:

Keywords: Injury, Rural Populations

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.

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The 132nd Annual Meeting (November 6-10, 2004) of APHA