LOW-INCOME NEIGHBORHOODS AND THE RISK OF SEVERE PEDIATRIC INJURY - A SMALL-AREA ANALYSIS IN NORTHERN MANHATTAN

Objectives. The purpose of this study was to investigate the relations hip between socioeconomic disadvantage and the incidence of severe chi ldhood injury. Methods. Small-area analysis was used to examine socioe conomic risk factors for pediatric injury resulting in hospitalization or death in Northern Manhattan, New York, NY, during a 9-year period (1983 through 1991). Results. The average annual incidence of all caus es of severe pediatric injury was 72.5 per 10 000 children; the case-f atality rate was 2.6%. Census tract proportions of low-income househol ds, single-parent families, non-high school graduates, and unemploymen t were significant predictors of risk for both unintentional and inten tional injury. Among the socioeconomic factors considered, low income was the single most important predictor of all injuries; other socioec onomic variables were not independent contributors once income was inc luded in the model. Compared with children living in areas with few lo w-income households, children in areas with predominantly low-income h ouseholds were more than twice as likely to receive injuries from all causes and four and one half times as likely to receive assault injuri es. The effect of neighborhood income disparities on injury risk persi sted after race was controlled. Conclusions. These results illuminate the impact of socioeconomic disparities on child health and point to t he need for injury prevention efforts targeting low-income neighborhoo ds.