The impact of the Safe Kids/Healthy Neighborhoods injury prevention program in Harlem, 1988 through 1991

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 preintervention 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. (Am J Public Health. 1994;84:580-586)
Community programs specifically aimed at reducing injuries to school-age children appear to have mixed results. The Safe Kids/Health Neighborhood Coalition in Central Harlem, New York City, was designed to reduce injuries to children aged 5-17. The methods used included cleaning up and repairing playgrounds, teaching pedestrian safety, providing supervised activities and providing inexpensive safety equipment in the form of bicycle helmets. In the first three years, from 1989 through 1991, the program appears to have reduced overall injuries to school age children, compared to earlier years. Injury rates among younger children on whom the program did not focus remained similar to earlier years. However, motor vehicle injury rates, a particular focus, fell in neighboring Washington Heights also. Little change in outdoor falls was found, despite more supervision and improved play areas. Additional research from more specific records and with methods to control for confounding changes is needed.