Racial Differences in Hospitalizations Due to Injuries in South Dakota Children and Adolescents
- 7 Downloads
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.
KeywordsRace disparities Health disparities Injury Hospital American Indian Suicide
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.
- 2.Barell V, Aharonson-Daniel L, Fingerhut LA, Mackenzie EJ, Ziv A, Boyko V, ..., Heruti R An introduction to the Barell body region by nature of injury diagnosis matrix. Inj Prev, 2002 8, 91–96.Google Scholar
- 3.Bergen G, Chen LH, Warner M, Fingerhut LA. Injury in the United States: 2007 Chartbook. Hyattsville, MD: National Center for Health Statistics; 2008.Google Scholar
- 4.Bernard SJ, Paulozzi LJ, Wallace DLJ. Fatal injuries among children by race and ethnicity--United States, 1999-2002. MMWR. 2007;56(SS05):1–16.Google Scholar
- 7.Blustein J. The reliability of racial classifications in hospital discharge abstract data. Am J Public Health. 1994;83(5):681–4.Google Scholar
- 9.Borse N, Sleet DA. CDC childhood injury report: patterns of unintentional injuries among 0- to 19-year olds in the United States, 2000-2006. Fam Community Health. 2009;32(2):189. https://doi.org/10.1097/01.fch.0000347986.44810.59.CrossRefGoogle Scholar
- 10.Borse N, Gilchrist J, Dellinger AM, Rudd RA, Ballesteros MF, Sleet DA. CDC childhood injury report: patterns of unintentional injuries among 0- to 19-year old in the United States. 32nd ed. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2008. p. 2000–6.Google Scholar
- 11.Centers for Disease Control and Prevention - National Center for Injury Prevention and Control. (2012). National Action Plan for Child Injury Prevention. Atlanta, GA: CDC, NCIPC.Google Scholar
- 12.Centers for Disease Control and Prevention. National Center for Injury Prevention and Control. (2018). Web-based Injury Statistics Query and Reporting System (WISQARS) [Online]. Retrieved from http://webappa.cdc.gov/sasweb/ncipc/nfirates2001.html. Accessed 9 Jul 2019
- 13.Children’s Safety Network. (2015). 2015 United States Fact Sheet. Retrieved from https://www.childrenssafetynetwork.org/state/united-states/2015. Accessed 9 Jul 2019
- 16.Curtin SC, Warner M, & Hedegaard H. Increase in suicide in the United States, 1999-2014. NCHS Data Brief 2016;(241), 1–8.Google Scholar
- 21.Heron M. Deaths: leading causes for 2014. MD: Retrieved from Hyattsville; 2016.Google Scholar
- 22.Johnson SJ, Sullivan M, Grossman DC. Hospitalizations for injury among American Indian youth in Washington. West J Med. 1999;171(1):10–4.Google Scholar
- 24.Korenbrot CC, Ehlers S, Crouch JA. Disparities in hospitalizations of rural American Indians. Med Care. 2003;41(5):626–36.Google Scholar
- 27.Martin, C. A., Unni, P., Landman, M. P., Feurer, I. D., McMaster, A., Dabrowiak, M., ..., Lovvorn III, H. N. Race disparities in firearm injuries and outcomes among Tennesse children. J Pediatr Surg, 2012;47, 1196–1203.Google Scholar
- 29.Smith N, Iyer RL, Langer-Gould A, Getahun DT, Strickland D, Jacobsen SJ, ..., Koebnick C (2010). Health plan administrative records versus birth certificate records: quality of race and ethnicity information in children. BMC Health Serv Res, 10, 316–322.Google Scholar