Fatal injuries among children by race and ethnicity--United States, 1999-2002.

PROBLEM/CONDITION In the United States, unintentional injury, homicide, and suicide are the first, second, and fourth leading causes of death among persons aged 1-19 years, respectively; the highest rates have occurred among minority populations. The effects of age on the difference in rates between white and minority children and the mechanisms of injury that contribute most to that difference have not been previously reported. REPORTING PERIOD COVERED Data are presented for fatal injuries among children in the United States by race/ethnicity and mechanism of injury during 1999-2002. Trends in injury mortality by race/ethnicity are provided for 1982-2002. DESCRIPTION OF SYSTEM Fatal injury data were derived from death certificates reported through CDC's National Vital Statistics System. RESULTS During 1999-2002, among infants aged <1 year, American Indian/Alaska Natives (AI/ANs) and blacks had consistently higher total injury death rates than other racial/ethnic populations. Both populations had more than twice the rate of injury death compared with white infants. Black infants had the highest rates of unintentional suffocation and homicide, whereas AI/AN infants had the highest rate of motor-vehicle (MV)-traffic death. Among children aged 1-9 years, AI/ANs and blacks had the highest injury death rates. AI/ANs aged 1-9 years had the highest rates of MV-traffic death and drowning; in contrast, blacks aged 1-9 years had the highest rates of homicide and fire/burn death. Among children aged 10-19 years, AI/ANs and blacks consistently had higher total injury death rates than whites. AI/ANs aged 10-19 years had the highest rates of suicide and MV-traffic death, and blacks aged 10-19 years had the highest rates of homicide. The disparity in injury mortality rates by race/ethnicity during 1982-1985 had not declined by 1999-2002. INTERPRETATION Significant disparities in injury rates still exist between white and minority children. Disparities varied by age and mechanism of injury. Hispanics and Asian/Pacific Islanders consistently had lower risk, whereas AI/ANs and blacks consistently had higher risk for fatal injuries than other racial/ethnic populations. PUBLIC HEALTH ACTIONS Educational, regulatory, and environmental modification strategies (e.g., home visitation programs, safety-belt laws, and swimming pool fencing) have been developed for each type of injury for use by health-care providers and government agencies.