Racial Differences in Hospitalizations Due to Injuries in South Dakota Children and Adolescents

  • Wei Bai
  • Bonny SpeckerEmail author



To determine racial differences and trends in pediatric injury hospitalization rates in a rural state.


Hospital inpatient discharge data (2009–2014) for South Dakota residents aged 0–19 years were used to calculate annual hospitalization rates due to injuries. Race-, age-, and sex-specific rates were calculated, and trends over time were determined.


Between 2009 and 2014, there were 3701 pediatric hospitalizations (1008 American Indian [AI]; 2303 white) due to injuries at an average rate of 269/100,000 (95% CI 260–280/100,000). Injury hospitalization rates were higher for AI than white children (532 vs. 213 per 100,000, respectively; p < 0.001). Rates for both AI and white children increased between 2009 and 2014 (both, p < 0.001). Suicide attempts were the predominant manner of injury in both the 10–14- and 15–19-year age groups, with AI adolescents having 3.5 and 3.2 times higher rates than white adolescents. Among AI adolescents aged 15 to 19 years, hospitalizations due to homicide-related injuries were 12.6 times higher than that of white children. Injury hospitalization rates among females recently exceeded that of males, due primarily to an increase in attempted suicides. Mechanism and nature of hospitalized injuries were consistent with the high rate of suicide-related admissions.


South Dakota AI children have disproportionately higher hospitalization rates due to unintentional and attempted suicide- and homicide-related injuries, and the rate differences between AI and white children are increasing over time. Injury hospitalization rates among females have increased more rapidly and recently surpassed that of males.


Race disparities Health disparities Injury Hospital American Indian Suicide 


Funding Information

This research was supported by the South Dakota Department of Health.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Supplementary material

40615_2019_611_MOESM1_ESM.docx (28 kb)
ESM 1 (DOCX 27 kb)


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Copyright information

© W. Montague Cobb-NMA Health Institute 2019

Authors and Affiliations

  1. 1.EA Martin ProgramSouth Dakota State UniversityBrookingsUSA

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