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Objectives. This study evaluated the effectiveness of a community coalition to prevent severe injuries to children in Central Harlem, New York, NY. It was hypothesized that injury incidence rates would decline during the intervention (1989 through 1991) relative to pre intervention years (1983 through 1988); that the decline would be greatest for the targeted age group (5 through 16 years) and targeted injury causes (traffic accidents, assaults, firearms, outdoor falls); and that the decline would occur in the intervention community rather than a control community. Methods. Surveillance of injuries that result in hospitalization and/or death among children in the two communities has been under way since 1983. Data from this surveillance were used to test whether the incidence of severe injury declined during the intervention; other temporal variations were controlled by Poisson regression. Results. The incidence of injury among school-aged children in central Harlem declined during the intervention. The decline was specific to the targeted age group and targeted causes. A nonspecific decline also occurred in the control community. Conclusions. The declining incidence rate in Central Harlem is consistent with a favorable program effect, but additional investigation of possible secular trend or spillover effects is needed. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to investigate the relationship between socioeconomic disadvantage and the incidence of severe childhood injury. Methods: Small-area analysis was used to examine socioeconomic 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 causes of severe pediatric injury was 72.5 per 10,000 children; the case-fatality rate was 2.6%. Census tract proportions of low-income households, single-parent families, non-high school graduates, and unemployment were significant predictors of risk for both unintentional and intentional injury. Among the socioeconomic factors considered, low income was the single most important predictor of all injuries; other socioeconomic variables were not independent contributors once income was included in the model. Compared with children living in areas with few low-income households, children in areas with predominantly low-income households were more than twice as likely to receive injuries from all causes and four and one half times as likely to receive assault injuries. The effect of neighborhood income disparities on injury risk persisted after race was controlled. Conclusions: These results illuminate the impact of socioeconomic disparities on child health and point to the need for injury prevention efforts targeting low-income neighborhoods. [ABSTRACT FROM AUTHOR]

Objectives. A prospective study of children examined both before and after a flood disaster in Bangladesh is used to test the hypothesis that stressful events play a causal role in the development of behavioral disorders in children. Methods. Six months before the disaster, structured measures of selected behavioral problems were made during an epidemiological study of disability among 2- to 9-year-old children. Five months after the disaster, a representative sample of 162 surviving children was reevaluated. Results. Between the pre- and postflood assessments, the prevalence of aggressive behavior increased from zero to nearly 10%, and 45 of the 134 children who had bladder control before the flood (34%) developed enuresis. Conclusions. These results help define what may be considered symptoms of posttraumatic distress in childhood; they also contribute to mounting evidence of the need to develop and evaluate interventions aimed at ameliorating the behavioral and psychological consequences of children's exposure to extreme and traumatic situations. [ABSTRACT FROM AUTHOR]

The article presents the editor's views on a study on violence against women, initiated by Grisso and colleagues and published in this issue. The researchers lament that much health research on violence has focused solely on men. Thus, they present a population-based study of injury morbidity among women in inner-city African American community in Philadelphia, Pennsylvania. The researchers emphasize the role that violence towards women plays in determining injury incidence. The study contributes to the literature on the epidemiology and prevention on violence towards women.

A letter to the editor is presented in response to the article "The Impact of the Safe Kids/Healthy Neighborhoods Injury Prevention Program in Harlem, 1988 Through 1991," which appeared in a 1994 issue of the "American Journal of Public Health."

A letter to the editor about the limited role of health departments in injury prevention is presented.