Past-Year Intentional and Unintentional Injury Among Teens Treated in an Inner-City Emergency Department

Cunningham, Rebecca M.; Walton, Maureen A.; Roahen Harrison, Stephanie; Resko, Stella M.; Stanley, Rachel; Zimmerman, Marc; Bingham, C. Raymond; Shope, Jean T.

doi:10.1016/j.jemermed.2009.11.024

« Previous Next »The Journal of Emergency Medicine
Volume 41, Issue 4 , Pages 418-426, October 2011

Past-Year Intentional and Unintentional Injury Among Teens Treated in an Inner-City Emergency Department

Rebecca M. Cunningham, MD
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan
- School of Public Health, University of Michigan, Ann Arbor, Michigan
- Reprint Address: Rebecca M. Cunningham, md, Injury Research Center, University of Michigan, 300 North Ingalls, Room 2C40, Ann Arbor, MI 48109-5437
Maureen A. Walton, MPH, PHD
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
Stephanie Roahen Harrison, MPH, PHD
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan
Stella M. Resko, MSW, PHD
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
Rachel Stanley, MD, MSHA
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan
Marc Zimmerman, MS, PHD
- School of Public Health, University of Michigan, Ann Arbor, Michigan
C. Raymond Bingham, MS, PHD
- School of Public Health, University of Michigan, Ann Arbor, Michigan
- Transportation Research Institute, University of Michigan, Ann Arbor, Michigan
Jean T. Shope, MSPH, PHD
- School of Public Health, University of Michigan, Ann Arbor, Michigan
- Transportation Research Institute, University of Michigan, Ann Arbor, Michigan

Received 24 June 2009; received in revised form 29 October 2009; accepted 9 November 2009. published online 11 February 2010.

Abstract

An inner-city emergency department (ED) visit provides an opportunity for contact with high-risk adolescents to promote injury prevention. Objectives: To identify the prevalence of injuries sustained over the past year by teens presenting to an inner-city ED, and to identify factors associated with recent injury to inform future ED-based injury prevention initiatives. Methods: Over 1 year, 7 days a week, from 1:00–11:00 p.m., patients aged 14–18 years presenting to the ED participated in a survey regarding past-year risk behaviors and injuries. Results: Of the entire group of teens presenting to the ED (n = 1128) who completed the survey (83.8% response rate), 46% were male, and 58% were African-American. Past-year injuries were reported by 768 (68.1%) of the teens; 475 (61.8%) of those reported an unintentional injury and 293 (38.1%) reported an intentional injury. One-third of all youth seeking care reported a past-year sports-related injury (34.5%) or an injury related to driving or riding in a car (12.3%), and 8.2% reported a gun-related injury. Logistic regression found that binge drinking (adjusted odds ratio [AOR] 1.95) and illicit weapon carrying (AOR 2.31) predicted a past-year intentional injury. African-American youth (AOR 0.56) and those receiving public assistance (AOR 0.73) were less likely to report past-year unintentional injuries. Conclusions: Adolescents seeking care in an inner-city ED, regardless of the reason for seeking care, report an elevated prevalence of recent injury, including violence. Future injury screening and prevention efforts should consider universal screening of all youth seeking ED care.

Keywords: emergency department, adolescents, injury prevention