Skip to main content
PMC home page
Public Health Reports logoLink to Public Health Reports
. 1996 Jul-Aug;111(4):321–327.

Trauma among American Indians in an urban county.

J R Sugarman 1, D C Grossman 1
PMCID: PMC1381875  PMID: 8711098

Abstract

OBJECTIVE. To describe severe injury among American Indians in a large metropolitan county given that most previous studies of the high Indian injury morbidity and mortality rates have been conducted primarily in rural areas. METHODS. A retrospective analysis of a hospital trauma registry was conducted for the years 1986-92 at the Harborview Medical Center, the only Level I trauma center in King County, Washington, metropolitan county with the seventh largest number of urban American Indians in the United States. RESULTS. Of 14,851 King County residents included in the registry, 593 (4%) were classified as American Indian. With King County whites as the reference, the age-standardized incidence ratio for inclusion of American Indians in the registry was 4.4 (95% confidence interval 4.1, 4.8). The standardized incidence ratios and proportional incidence ratios showed significant differences in mechanism and whether it was intentional or unintentional among Indians compared with whites. Hospitalizations for stab wounds, bites, and other blunt trauma were all significantly more frequent among Indians. Trauma admissions among Indians were disproportionately associated with assaults. A high proportion (72.3%) of American Indians tested had blood alcohol levels exceeding 0.1%. CONCLUSION. Urban American Indians experience high rates of trauma, differing from those among whites. Efforts to reduce injury in urban areas should include collaboration with representative urban American Indian organizations.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ballard J. E., Koepsell T. D., Rivara F. P., Van Belle G. Descriptive epidemiology of unintentional residential fire injuries in King County, WA, 1984 and 1985. Public Health Rep. 1992 Jul-Aug;107(4):402–408. [PMC free article] [PubMed] [Google Scholar]
  2. Frost F., Taylor V., Fries E. Racial misclassification of Native Americans in a surveillance, epidemiology, and end results cancer registry. J Natl Cancer Inst. 1992 Jun 17;84(12):957–962. doi: 10.1093/jnci/84.12.957. [DOI] [PubMed] [Google Scholar]
  3. Gallaher M. M., Fleming D. W., Berger L. R., Sewell C. M. Pedestrian and hypothermia deaths among Native Americans in New Mexico. Between bar and home. JAMA. 1992 Mar 11;267(10):1345–1348. [PubMed] [Google Scholar]
  4. Gelberg L., Linn L. S. Assessing the physical health of homeless adults. JAMA. 1989 Oct 13;262(14):1973–1979. [PubMed] [Google Scholar]
  5. Grossman D. C., Krieger J. W., Sugarman J. R., Forquera R. A. Health status of urban American Indians and Alaska Natives. A population-based study. JAMA. 1994 Mar 16;271(11):845–850. [PubMed] [Google Scholar]
  6. Hibbs J. R., Benner L., Klugman L., Spencer R., Macchia I., Mellinger A., Fife D. K. Mortality in a cohort of homeless adults in Philadelphia. N Engl J Med. 1994 Aug 4;331(5):304–309. doi: 10.1056/NEJM199408043310506. [DOI] [PubMed] [Google Scholar]
  7. MacKenzie E. J., Steinwachs D. M., Shankar B. Classifying trauma severity based on hospital discharge diagnoses. Validation of an ICD-9CM to AIS-85 conversion table. Med Care. 1989 Apr;27(4):412–422. doi: 10.1097/00005650-198904000-00008. [DOI] [PubMed] [Google Scholar]
  8. Padgett D. K., Struening E. L. Victimization and traumatic injuries among the homeless: associations with alcohol, drug, and mental problems. Am J Orthopsychiatry. 1992 Oct;62(4):525–534. doi: 10.1037/h0079369. [DOI] [PubMed] [Google Scholar]
  9. Schwarz D. F., Grisso J. A., Miles C. G., Holmes J. H., Wishner A. R., Sutton R. L. A longitudinal study of injury morbidity in an African-American population. JAMA. 1994 Mar 9;271(10):755–760. [PubMed] [Google Scholar]
  10. Sugarman J. R., Lawson L. The effect of racial misclassification on estimates of end-stage renal disease among American Indians and Alaska Natives in the Pacific Northwest, 1988 through 1990. Am J Kidney Dis. 1993 Apr;21(4):383–386. doi: 10.1016/s0272-6386(12)80265-4. [DOI] [PubMed] [Google Scholar]
  11. Sugarman J. R., Soderberg R., Gordon J. E., Rivara F. P. Racial misclassification of American Indians: its effect on injury rates in Oregon, 1989 through 1990. Am J Public Health. 1993 May;83(5):681–684. doi: 10.2105/ajph.83.5.681. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Public Health Reports are provided here courtesy of SAGE Publications

RESOURCES