Prevention of traumatic deaths to children in the United States: how far have we come and where do we need to go?

Abstract

Objective: To describe the changes in injury mortality from 1978 to 1991 and determine the number of preventable deaths with currently available intervention strategies.

Methods: Comparison of injury mortality data for children and adolescents 0 to 19 years in 1978 and 1991. Review of the literature to determine the effectiveness of currently available prevention strategies and application of these to deaths in 1991.

Results: The injury death rate declined by 26% over the 14-year period. Death rates of unintentional injuries decreased by 39%, with declines in all categories of unintentional injuries. Homicides increased by 67% and suicides by 17%; nearly all of this increase was in deaths from firearms. If currently available prevention strategies were fully used, 6640 deaths could have been prevented, a further 31% decrease.

Conclusions: Although great studies have been made in preventing deaths from trauma, the application of currently available prevention strategies could save a large number of additional lives. However, the increasing problem of intentional injury will partly counterbalance the success in unintentional injury control.