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Donald F. Schwarz, MD, MPH; Jeane Ann Grisso, MD, MSc; Carolyn G. Miles, MPH; John H. Holmes, MS; Amy R. Wishner, RN, MSN; Rudolph L. Sutton, MPH

JAMA. 1994;271(10):755-760.

Abstract
Objective.
—To improve understanding of the patterns of injury morbidity and mortality in an urban African-American population.

Design.
—Prospective survey of emergency department records for a geographically defined population from 1987 through 1990.

Setting.
—Eleven hospital emergency departments in Philadelphia, Pa.

Participants.
—The approximately 68000 people living in 17 census tracts in western Philadelphia.

Results.
—A total of 46260 injury events were identified in the survey (168.8 events per 1000 population annually). Half of the population made an emergency department visit for one or more injuries during the 4 years of study. There were 2796 hospital admissions (10.2/1000 population) and 403 deaths (1.5/1000 population) as a result of these injuries. Although in 1987 falls were the most frequent type of injury resulting in an emergency department visit, by 1989 the number of interpersonal intentional injury events exceeded the number of falls. Interpersonal intentional injuries accounted for 31.2% of hospital admissions and 42.7% of deaths. Of men 20 through 29 years old, 94.3% visited an emergency department at least once in the 4 years because of an injury, and 40.9% of men in this age group sought treatment for one or more interpersonal intentional injuries. The likelihood of future interpersonal intentional injury—related visits increased with the number of previous injuries of this type.

Conclusions.
—Interpersonal intentional injury occurs frequently in this population. More attention needs to be paid to prevention and intervention to reduce the toll of this violence. The high prevalence of injury in certain age strata may make general, population-based efforts for injury prevention more efficient than efforts targeted to subgroups.

(JAMA. 1994;271:755-760)

Author Affiliations
From the Department of Pediatrics (Dr Schwarz) and the Clinical Epidemiology Unit (Dr Grisso and Mr Holmes), University of Pennsylvania School of Medicine, The Children's Hospital of Philadelphia (Ms Miles), and the Philadelphia Department of Public Health (Ms Wishner and Mr Sutton), Philadelphia, Pa.

Footnotes
Reprint requests to Division of General Pediatrics, Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104 (Dr Schwarz).

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