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

  • Wei Bai
  • Bonny SpeckerEmail author
Article
  • 7 Downloads

Abstract

Objectives

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

Methods

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.

Results

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.

Conclusion

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.

Keywords

Race disparities Health disparities Injury Hospital American Indian Suicide 

Notes

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)

References

  1. 1.
    Agran PF, Winn DG, Anderson CL, Del Valle CP. Pediatric injury hospitalization in Hispanic children and non-Hispanic white children in southern California. Arch Pediatr Adolesc Med. 1996;150(4):400–6.CrossRefGoogle Scholar
  2. 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. 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. 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
  5. 5.
    Bernburg JG, Thorlindsson T, Sigfusdottir ID. The spreading of suicidal behavior: the contextual effect of community household poverty on adolescent suicidal behavior and the mediating role of suicide suggestion. Soc Sci Med. 2009;68:380–9.CrossRefGoogle Scholar
  6. 6.
    Bigback KM, Hoopes M, Dankovchik J, Knaster E, Warren-Mears V, Joshi S, et al. Using record linkage to improve race data quality for American Indians and Alaska natives in two pacific northwest state hospital discharge databases. Health Serv Res. 2015;50(S1):1390–402.CrossRefGoogle Scholar
  7. 7.
    Blustein J. The reliability of racial classifications in hospital discharge abstract data. Am J Public Health. 1994;83(5):681–4.Google Scholar
  8. 8.
    Borowsky IW, Resnick MD, Ireland M. Suicide attempts among American Indians and Alaska native youth: risk and protective factors. Arch Pediatr Adolesc Med. 1999;153(6):573–80.CrossRefGoogle Scholar
  9. 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. 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. 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. 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. 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
  14. 14.
    Christensen M, Kightlinger L. Premature mortality patterns among American Indians in South Dakota, 2000-2010. Am J Prev Med. 2013;44(5):465–71.  https://doi.org/10.1016/j.amepre.2013.01.014.CrossRefGoogle Scholar
  15. 15.
    Committee on Native American Child Health and Committee on Injury and Poison Prevention. The prevention of unintentional injury among American Indian and Alaska native children: a subject review. Pediatr. 1999;104(6):1397–9.CrossRefGoogle Scholar
  16. 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
  17. 17.
    Cutler GJ, Flood A, Dreyfus J, Ortega HW, Kharbanda AB. Emergency department visits for self-inflicted injuries in adolescents. Pediatr. 2015;136(1):28–34.CrossRefGoogle Scholar
  18. 18.
    Fontanella CA, Hiance-Steelesmith DL, Phillips GS, Bridge JA, Lester N, Sweeney HA, et al. Widening rural-urban disparities in youth suicides, United States, 1996-2010. JAMA Pediatr. 2015;169(5):466–73.CrossRefGoogle Scholar
  19. 19.
    Freedenthal S, Stiffman AR. Suicidal behavior in urban American Indian adolescents: a comparison with reservation youth in a southwestern state. Suicide Life Threat Behav. 2004;34:160–71.CrossRefGoogle Scholar
  20. 20.
    Freedenthal S, Stiffman AR. “They might think I was crazy”: young American Indians’ reasons for not seeking help when suicidal. J Adolesc Res. 2007;22(1):58–77.CrossRefGoogle Scholar
  21. 21.
    Heron M. Deaths: leading causes for 2014. MD: Retrieved from Hyattsville; 2016.Google Scholar
  22. 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
  23. 23.
    Kim K, Ozegovic D, Voaklander DC. Differences in incidence of injury between rural and urban children in Canada and the USA: a systematic review. Inj Prev. 2012;18(4):264–71.CrossRefGoogle Scholar
  24. 24.
    Korenbrot CC, Ehlers S, Crouch JA. Disparities in hospitalizations of rural American Indians. Med Care. 2003;41(5):626–36.Google Scholar
  25. 25.
    LaFromboise TD, Hoyt DR, Oliver L, Whitbeck LB. Family, community, and school influences on resilience among American Indian adolescents in the upper Midwest. Am J Community Psychol. 2006;34(2):193–209.CrossRefGoogle Scholar
  26. 26.
    Liu X, Huang Y, Liu Y. Prevalence, distribution, and associated factors of suicide attempts in young adolescents: school-based data from 40 low-income and middle-income countries. PLoS One. 2018;13(12):e0207823.CrossRefGoogle Scholar
  27. 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
  28. 28.
    Pressley JC, Barlow B, Kindig T, Paneth-Pollak R. Twenty-year trends in fatal injuries to very young children: the persistence of racial disparities. Pediatr. 2007;119(4):e875–84.CrossRefGoogle Scholar
  29. 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
  30. 30.
    Sugarman JR, Soderberg R, Gordon JE, Rivara FP. Racial misclassification of American Indians: its effect on injury rates in Oregon, 1989 through 1990. Am J Public Health. 1993;83(5):681–4.CrossRefGoogle Scholar

Copyright information

© W. Montague Cobb-NMA Health Institute 2019

Authors and Affiliations

  1. 1.EA Martin ProgramSouth Dakota State UniversityBrookingsUSA

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