Relationship between behavioral problems and unintentional injuries in US children. Findings of the 1988 National Health Interview Survey
R. Bussing, E. Menvielle and B. Zima
Department of Psychiatry, University of Florida, Gainesville, USA.
OBJECTIVE: To investigate (1) the incidence of unintentional injuries among
children with and without behavioral problems and (2) the role of ethnicity
on the relationship between behavioral problems and risk for unintentional
injuries, as unintentional injuries among children represent a major public
health concern in the United States. DESIGN: Cross-sectional analysis of
data on 11 630 children contained in the 1988 National Health Interview
Survey. MAIN OUTCOME MEASURES AND METHODS: We studied the annual incidence
of unintentional injury and its relationship to child behavioral problems
among three ethnic groups (white, African American, and Hispanic) through
stratified as well as multivariate analytic models. RESULTS: Accident rates
were higher in white children (17.9%) than in African-American (9.3%) or
Hispanic (9.3%) children. The odds of unintentional injury in children with
severe behavioral problems was 1.65 times greater than in children without
behavioral problems, after controlling for relevant sociodemographic
characteristics. Ethnicity did not alter the relationship between overall
behavioral problems and increased injury rates; however, ethnic differences
emerged in the subscale analysis of disruptive behaviors. CONCLUSIONS:
Children with behavioral problems represent a significant risk group for
unintentional injuries among three ethnic groups in the United States.
These findings emphasize the need to implement accident prevention
strategies that are specially targeted at children with behavioral
disorders.