Black children are more than twice as likely to die from a traumatic injury as are white children

May 15 2005

A new study of nearly 6,000 children suggests that black youth are more than twice as likely to die from a traumatic injury as are white children.

“Trauma has a far greater impact on minority children than it does on white children,” said Jonathan Groner, the study's lead author and a clinical associate professor of surgery at Ohio State University . “As a group, black children tend to have more serious injuries.”

Indeed, black children are also two to three times more likely to be admitted to the hospital because of a traumatic injury.

However, when black and white children are admitted to the hospital with equally severe i

njuries, they have an equal chance of survival, spend about the same amount of time in the hospital, and also have equal access to rehabilitation services.

“Trauma-induced injuries are mainly a problem of prevention, not a problem of treatment,” said Groner, who is also the trauma medical director at Columbus Children's Hospital. “Trauma is a disease – it can be prevented and it has recognizable risk factors.”

The findings are reported in a recent issue of the Journal of the National Medical Association. Groner conducted the study with John Hayes, a statistician with the trauma program at Columbus Children's Hospital.

The study sample included the medical records of 5,973 children who received emergency inpatient treatment at one of six pediatric trauma centers in Ohio . (Trauma centers were located in Columbus , Cleveland , Cincinnati , Dayton , Toledo and Akron .)

The researchers also gathered information from the 2000 U.S. census and from death certificate data from the Ohio Bureau of Vital Statistics. Data were collected for injuries that happened in 1999, 2000 and 2001. Information included the cause of the injury and, in most cases, the zip code where the injury occurred.

All of the children were younger than 16 at the time of their injuries. Information was included only for patients who came to an emergency department and were subsequently admitted to the hospital or died after treatment in the emergency room.

Although Groner and Hayes gathered data from Ohio 's four largest minority groups – African American, Native American, Hispanic and Asian – the latter three groups made up a very small portion of the trauma cases.

“This study principally compares black and white children, as the other populations were too small to give us reliable numbers,” Groner said.

At the time of the study, 12.3 percent of Ohio children 15 and younger were black. But these children accounted for 28 percent of the trauma cases.

Compared to white children, black children were:

• Nearly eight times more likely to sustain burns or gunshot wounds;
• Seven times more likely to be struck by a car;
• Six times more likely to be assaulted (the number includes cases of child abuse);
• Nearly five times as likely to drown; and
• Had a greater risk of dying from a traumatic injury, because their injuries tend to be more severe. (The overall risk of a black child dying was 2.2 times greater than that of a white child.)

The researchers also found that suicide rates begin to rise for both black and white children around age 10.

“Suicide isn't generally thought to be an issue until a child reaches his early teens,” Groner said. “Our findings demonstrate that parents, school officials and mental health professionals need to be aware of the potential for suicide in pre-teen children.”

Part of the reason why black children may be more susceptible to serious injury is due to their environment, Groner said.

“When we looked at the social and economic data, we saw that many traumatic injuries – particularly assaults and burns – corresponded with the severity of poverty,” he said. “Overall, black children tend to live in places where the potential for serious injury is higher.”

As with many illnesses, Groner said that prevention is the key to keeping children safe from traumatic injuries.

“If a child doesn't have a primary care physician and instead comes into the emergency room for care, his or her caregivers are probably less likely to receive injury prevention information than they would if the child made regular visits to an established doctor,” Groner said.

“And it's possible that prevention campaigns have targeted geographic and social centers where African Americans or other minorities are not broadly present.”

This study was funded by Ohio Emergency Medical Services, a division of the Ohio Department of Public Safety.