枪支和机动车儿童死亡——年龄、性别、种族和民族的交叉。

IF 24.7 1区 医学 Q1 PEDIATRICS
Lois K Lee, Suk-Fong S Tang, William L Cull, Eric W Fleegler, Lynn M Olson
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引用次数: 0

摘要

重要性:枪支伤害和机动车碰撞(MVCs)是美国0至19岁儿童和青少年死亡的主要原因。检查年龄组、性别、种族和民族的交叉点对于集中预防工作至关重要。目的:按人口亚群检查枪支和机动车死亡率,并分析随时间的变化。设计、设置、参与者:这项横断面研究对2011年至2021年美国疾病控制和预防中心基于网络的伤害统计和查询报告系统中0至19岁的美国儿童和青少年的枪支和MVC死亡进行了研究。参与者包括美国印第安人和阿拉斯加原住民;亚洲人、夏威夷原住民和太平洋岛民;黑色;拉美裔;和白人青年。数据分析时间为2023年7月至2024年5月。暴露:火器或MVC死亡。主要结果测量:火器和MVC死亡率按年和随时间变化,由Joinpoint回归年度百分比变化(APC)测量。结果:从2011年到2021年,美国0至19岁的年轻人中有35 684例枪支死亡和40 735例MVC死亡。对于枪支死亡,有21起 332起杀人(59.8%),12起 113起自杀(33.9%),1359起非故意枪击(3.8%),277起执法(0.8%),603起不明意图(1.6%)。在考虑年龄组、性别、种族和民族的交叉点时,在15至19岁的青少年中,2018年至2021年,黑人(21.8%)和西班牙裔(22.2%)男性的枪支杀人率相似,尽管峰值率不同(2021年分别为104.22 / 100 000和17.80 / 100 000)。从2019年到2021年,15至19岁的黑人女性的APC急剧增加了40.7%(峰值率为14.07 / 100,000 000)。从性别来看,10至19岁青少年的枪支自杀率,黑人女性的APC增幅最大,从2016年到2021年增长了22.0%。对于MVC死亡人数,2018年至2021年期间,15至19岁的美洲印第安人和阿拉斯加原住民女性的APC增幅最高,为24.9%。2021年,15至19岁的美洲印第安人和阿拉斯加土著男性(38.16 / 100,000 万人)和女性(29.31 / 100,000 万人)的MVC死亡率最高。结论和相关性:在这项横断面研究中,美国0至19岁的年轻人在枪支和MVC死亡率方面存在重要差异,并且在考虑到年龄组、性别、种族和民族的交叉性时,随着时间的推移而增加。这些发现表明,针对每种伤害机制的特定高危人群,有必要采取多管齐下的策略,重点关注个人、社区和政策层面的方法,以解决美国青少年这些主要死亡原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Firearm and Motor Vehicle Pediatric Deaths-Intersections of Age, Sex, Race, and Ethnicity.

Importance: Injuries from firearms and motor vehicle crashes (MVCs) are the leading causes of death among US children and youths aged 0 to 19 years. Examining the intersections of age group, sex, race, and ethnicity is essential to focus prevention efforts.

Objective: To examine firearm and motor vehicle fatality rates by population subgroups and analyze changes over time.

Design, setting, participants: This cross-sectional study of firearm and MVC fatalities among US children and youths aged 0 to 19 years from the Centers for Disease Control and Prevention Web-Based Injury Statistics and Query Reporting System from 2011 to 2021. Participants included American Indian and Alaska Native; Asian, Hawaiian Native, and Pacific Islander; Black; Hispanic; and White youths. Data analysis was conducted from July 2023 to May 2024.

Exposure: Firearm or MVC fatality.

Main outcome measures: Firearm and MVC fatality rates by year and over time, as measured by the Joinpoint regression annual percent change (APC).

Results: From 2011 to 2021 there were 35 684 firearm and 40 735 MVC fatalities among US youths aged 0 to 19 years. For firearm fatalities, there were 21 332 homicides (59.8%), 12 113 suicides (33.9%), 1359 unintentional shootings (3.8%), 277 by legal enforcement (0.8%), and 603 from unknown intents (1.6%). When considering the intersections of age group, sex, race, and ethnicity, for firearm homicides among youths aged 15 to 19 years, the APCs were similar for Black (21.8%) and Hispanic (22.2%) males from 2018 to 2021, although with different peak rates (104.22 per 100 000 individuals and 17.80 per 100 000 individuals, respectively, in 2021). Black females aged 15 to 19 years demonstrated a dramatic APC increase of 40.7% from 2019 to 2021 (peak rate, 14.07 per 100 000 individuals). For firearm suicide in youths aged 10 to 19 years by sex, Black females had the greatest APC increase of 22.0% from 2016 to 2021. For MVC fatalities, the highest APC increase of 24.9% occurred among American Indian and Alaska Native females aged 15 to 19 years from 2018 to 2021. The highest MVC fatality rates occurred in 2021 among American Indian and Alaska Native males (38.16 per 100 000 individuals) and females (29.31 per 100 000 individuals) aged 15 to 19 years.

Conclusions and relevance: In this cross-sectional study, US youths aged 0 to 19 years experienced important disparities in firearm and MVC fatality rates and increases over time when considering the intersectionality by age group, sex, race, and ethnicity. These findings suggest that a multipronged strategy focused on individual, community, and policy level approaches for specific high-risk groups for each injury mechanism is necessary to address these leading causes of death in US youths.

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来源期刊
JAMA Pediatrics
JAMA Pediatrics PEDIATRICS-
CiteScore
31.60
自引率
1.90%
发文量
357
期刊介绍: JAMA Pediatrics, the oldest continuously published pediatric journal in the US since 1911, is an international peer-reviewed publication and a part of the JAMA Network. Published weekly online and in 12 issues annually, it garners over 8.4 million article views and downloads yearly. All research articles become freely accessible online after 12 months without any author fees, and through the WHO's HINARI program, the online version is accessible to institutions in developing countries. With a focus on advancing the health of infants, children, and adolescents, JAMA Pediatrics serves as a platform for discussing crucial issues and policies in child and adolescent health care. Leveraging the latest technology, it ensures timely access to information for its readers worldwide.
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