Trauma among Indians in an urban county
Authors: Sugarman JR., Grossman DC.
Publication Year: 1996
Last Updated: 2010-01-21 08:14:08
Journal: Public Health Reports
Keywords: Adolescence; Adult; Aged; Alcoholism/Complications; Female; Headache; Hospitalization/Statistics & Numerical Data; Incidence; Male; Middle Age; Multiple Trauma/Etiology; Registries; Risk Factors; Trauma Centers; Urban Health; Violence; Wounds and Injuries/Epidemiology
Short Abstract: The authors describe patterns of serious injury among American Indians in an urban area by comparing characteristics of injuries leading to hospitalization among American Indians and persons of other races. Data are collected from the Harborview Medical Center Trauma Registry.
Abstract: American Indians have been reported to have high injury morbidity and mortality rates. Data describing serious injuries among American Indians not using Indian Health Service (IHS) or tribal facilities in Washington State are sparse. The authors describe patterns of serious injury among American Indians in an urban area by comparing characteristics of injuries leading to hospitalization among American Indians and persons of other races. Data are collected from the Harborview Medical Center Trauma Registry. In order to describe rates, mechanisms, and intentionality of severe injury among American Indians in a large metropolitan county, the authors conducted a retrospective analysis of a hospital-based trauma registry for the years 1986-1992. The facility at which the Harborview Medical Center Trauma Registry is based is the only Level 1 trauma center in King County, Washington. King County is a metropolitan county with the seventh largest number of urban American Indians in the United States. Of 14,851 King County residents included in the registry, 593 (4%) were classified as American Indian. With King County Anglos as the reference, the age-standardized incidence ratio (SIR) for inclusion of American Indians in the registry was 4.4. SIRs and proportional incidence ratios (PIRS) showed significant differences in mechanisms and intent of injury among American Indians compared to Anglos. Hospitalizations for stab wounds, bites, and other blunt trauma were significantly more frequent among American Indians and trauma admissions were disproportionately associated with assaults. A high proportion of American Indians tested had blood alcohol levels exceeding 0.1 percent. Urban Indians experience high rates of trauma with the distribution of mechanisms and intents differing from among Whites. Efforts to reduce injury in urban areas should include collaboration with representative urban American Indian organizations
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