RELATIONSHIP BETWEEN BEHAVIORAL-PROBLEMS AND UNINTENTIONAL INJURIES IN US CHILDREN - FINDINGS OF THE 1988 NATIONAL-HEALTH INTERVIEW SURVEY

Objective: To investigate (1) the incidence of unintentional injuries among children with and without behavioral problems and (2) the role o f ethnicity on the relationship between behavioral problems and risk f or unintentional injuries, as unintentional injuries among children re present a major public health concern in the United States. Design: Cr oss-sectional analysis of data on 11 630 children contained in the 198 8 National Health Interview Survey. Main Outcome Measures and Methods: We studied the annual incidence of unintentional injury and its relat ionship to child behavioral problems among three ethnic groups (white, African American, and Hispanic) through stratified as well as multiva riate analytic models. Results: Accident rates were higher in white ch ildren (17.9%) than in African-American (9.3%) or Hispanic (9.3%) chil dren. The odds of unintentional injury in children with severe behavio ral problems was 1.65 times greater than in children without behaviora l problems, after controlling for relevant sociodemographic characteri stics. Ethnicity did not alter the relationship between overall behavi oral problems and increased injury rates; however, ethnic differences emerged in the subscale analyses of disruptive behaviors. Conclusions: Children with behavioral problems represent a significant risk group for unintentional injuries among three ethnic groups in the United Sta tes. These findings emphasize the need to implement accident preventio n strategies that are specially targeted at children with behavioral d isorders.