Skip to main content
Injury Prevention logoLink to Injury Prevention
. 1998 Mar;4(1):33–38. doi: 10.1136/ip.4.1.33

Demographic risk factors for injury among Hispanic and non-Hispanic white children: an ecologic analysis

C Anderson 1, P Agran 1, D Winn 1, C Tran 1
PMCID: PMC1730333  PMID: 9595329

Abstract

Objectives—To determine the effects of neighborhood levels of poverty, household crowding, and acculturation on the rate of injury to Hispanic and non-Hispanic white children.

Setting—Orange County, California.

Methods—An ecologic study design was used with census block groups as the unit of analysis. Measures of neighborhood poverty, household crowding, and acculturation were specific to each ethnic group. Poisson regression was used to calculate mutually adjusted incidence rate ratios (IRRs) corresponding to a 20% difference in census variables.

Results—Among non-Hispanic white children, injury rates were more closely associated with neighborhood levels of household crowding (adjusted IRR 2.36, 95% confidence interval (CI) 1.22 to 4.57) than with neighborhood poverty (adjusted IRR 1.06, 95% CI 0.89 to 1.26). For Hispanic children, the strongest risk factors were the proportion of Hispanic adults who spoke only some English (compared with the proportion who spoke little or no English, adjusted IRR 1.26, 95% CI 1.04 to 1.53) and the proportion who were US residents for <5 years (adjusted IRR 1.20, 95% CI 1.001 to 1.43). Neighborhood levels of household crowding were not related to injury among Hispanic children (adjusted IRR 0.98, 95% CI 0.89 to 1.08), but surprisingly, neighborhood poverty was associated with lower injury rates (adjusted IRR 0.89, 95% CI 0.81 to 0.97).

Conclusions—Cultural and geographic transitions, as well as socioeconomic differences, appear to contribute to differences in childhood injury rates between ethnic groups.

Full Text

The Full Text of this article is available as a PDF (107.1 KB).

Selected References

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

  1. Aagran P. F., Winn D. G., Anderson C. L., Del Valle C. P. Pediatric injury hospitalization in Hispanic children and non-Hispanic white children in southern California. Arch Pediatr Adolesc Med. 1996 Apr;150(4):400–406. doi: 10.1001/archpedi.1996.02170290066011. [DOI] [PubMed] [Google Scholar]
  2. Alwash R., McCarthy M. Accidents in the home among children under 5: ethnic differences or social disadvantage? Br Med J (Clin Res Ed) 1988 May 21;296(6634):1450–1453. doi: 10.1136/bmj.296.6634.1450. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bagley C. The urban setting of juvenile pedestrian injuries: a study of behavioural ecology and social disadvantage. Accid Anal Prev. 1992 Dec;24(6):673–678. doi: 10.1016/0001-4575(92)90020-j. [DOI] [PubMed] [Google Scholar]
  4. Beautrais A. L., Fergusson D. M., Shannon F. T. Childhood accidents in a New Zealand birth cohort. Aust Paediatr J. 1982 Dec;18(4):238–242. [PubMed] [Google Scholar]
  5. Bijur P. E., Golding J., Kurzon M. Childhood accidents, family size and birth order. Soc Sci Med. 1988;26(8):839–843. doi: 10.1016/0277-9536(88)90176-1. [DOI] [PubMed] [Google Scholar]
  6. Braddock M., Lapidus G., Gregorio D., Kapp M., Banco L. Population, income, and ecological correlates of child pedestrian injury. Pediatrics. 1991 Dec;88(6):1242–1247. [PubMed] [Google Scholar]
  7. Dougherty G., Pless I. B., Wilkins R. Social class and the occurrence of traffic injuries and deaths in urban children. Can J Public Health. 1990 May-Jun;81(3):204–209. [PubMed] [Google Scholar]
  8. Durkin M. S., Davidson L. L., Kuhn L., O'Connor P., Barlow B. Low-income neighborhoods and the risk of severe pediatric injury: a small-area analysis in northern Manhattan. Am J Public Health. 1994 Apr;84(4):587–592. doi: 10.2105/ajph.84.4.587. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Emerick S. J., Foster L. R., Campbell D. T. Risk factors for traumatic infant death in Oregon, 1973 to 1982. Pediatrics. 1986 Apr;77(4):518–522. [PubMed] [Google Scholar]
  10. Fingerhut L. A., MaKuc D. M. Mortality among minority populations in the United States. Am J Public Health. 1992 Aug;82(8):1168–1170. doi: 10.2105/ajph.82.8.1168. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Greenland S. Divergent biases in ecologic and individual-level studies. Stat Med. 1992 Jun 30;11(9):1209–1223. doi: 10.1002/sim.4780110907. [DOI] [PubMed] [Google Scholar]
  12. Kendrick D. Prevention of pedestrian accidents. Arch Dis Child. 1993 May;68(5):669–672. doi: 10.1136/adc.68.5.669. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Krieger N. Overcoming the absence of socioeconomic data in medical records: validation and application of a census-based methodology. Am J Public Health. 1992 May;82(5):703–710. doi: 10.2105/ajph.82.5.703. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Krieger N., Williams D. R., Moss N. E. Measuring social class in US public health research: concepts, methodologies, and guidelines. Annu Rev Public Health. 1997;18:341–378. doi: 10.1146/annurev.publhealth.18.1.341. [DOI] [PubMed] [Google Scholar]
  15. Leon A. M., Mazur R., Montalvo E., Rodrieguez M. Self-help support groups for Hispanic mothers. Child Welfare. 1984 May-Jun;63(3):261–268. [PubMed] [Google Scholar]
  16. Matteucci R. M., Holbrook T. L., Hoyt D. B., Molgaard C. Trauma among Hispanic children: a population-based study in a regionalized system of trauma care. Am J Public Health. 1995 Jul;85(7):1005–1008. doi: 10.2105/ajph.85.7.1005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Morgenstern H. Ecologic studies in epidemiology: concepts, principles, and methods. Annu Rev Public Health. 1995;16:61–81. doi: 10.1146/annurev.pu.16.050195.000425. [DOI] [PubMed] [Google Scholar]
  18. Nelson M. D., Jr Socioeconomic status and childhood mortality in North Carolina. Am J Public Health. 1992 Aug;82(8):1131–1133. doi: 10.2105/ajph.82.8.1131. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Nersesian W. S., Petit M. R., Shaper R., Lemieux D., Naor E. Childhood death and poverty: a study of all childhood deaths in Maine, 1976 to 1980. Pediatrics. 1985 Jan;75(1):41–50. [PubMed] [Google Scholar]
  20. Olson L. M., Becker T. M., Wiggins C. L., Key C. R., Samet J. M. Injury mortality in American Indian, Hispanic, and non-Hispanic white children in New Mexico, 1958-1982. Soc Sci Med. 1990;30(4):479–486. doi: 10.1016/0277-9536(90)90350-2. [DOI] [PubMed] [Google Scholar]
  21. Rivara F. P., Barber M. Demographic analysis of childhood pedestrian injuries. Pediatrics. 1985 Sep;76(3):375–381. [PubMed] [Google Scholar]
  22. Roberts I. Sole parenthood and the risk of child pedestrian injury. J Paediatr Child Health. 1994 Dec;30(6):530–532. doi: 10.1111/j.1440-1754.1994.tb00727.x. [DOI] [PubMed] [Google Scholar]
  23. Sam D. L., Berry J. W. Acculturative stress among young immigrants in Norway. Scand J Psychol. 1995 Mar;36(1):10–24. doi: 10.1111/j.1467-9450.1995.tb00964.x. [DOI] [PubMed] [Google Scholar]
  24. Schwartz S. The fallacy of the ecological fallacy: the potential misuse of a concept and the consequences. Am J Public Health. 1994 May;84(5):819–824. doi: 10.2105/ajph.84.5.819. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Stewart-Brown S., Peters T. J., Golding J., Bijur P. Case definition in childhood accident studies: a vital factor in determining results. Int J Epidemiol. 1986 Sep;15(3):352–359. doi: 10.1093/ije/15.3.352. [DOI] [PubMed] [Google Scholar]
  26. Walsh S. S., Jarvis S. N. Measuring the frequency of "severe" accidental injury in childhood. J Epidemiol Community Health. 1992 Feb;46(1):26–32. doi: 10.1136/jech.46.1.26. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Wise P. H., Kotelchuck M., Wilson M. L., Mills M. Racial and socioeconomic disparities in childhood mortality in Boston. N Engl J Med. 1985 Aug 8;313(6):360–366. doi: 10.1056/NEJM198508083130605. [DOI] [PubMed] [Google Scholar]

Articles from Injury Prevention are provided here courtesy of BMJ Publishing Group

RESOURCES