An ecological assessment of the population and environmental correlates of childhood accident, assault, and child abuse injuries.

BACKGROUND This study examines the relationships of population and environmental characteristics to hospital discharges for childhood accident, assault, and child abuse injuries among youth from 0 to 17 years of age. METHODS The analysis uses aggregate data on populations and environments in 1,646 California zip code areas that were collected for the year 2000. Zero inflated negative binomial models were used to assess ecological relationships between these characteristics and numbers of hospital discharges for childhood injuries from accidents and assaults; negative binomial models were used to assess these relationships for injuries related to child abuse. RESULTS A number of different characteristics were related to the different injury outcomes. Childhood accident injuries were related to measures female headed households, adult to child ratio, and nonalcohol retail establishments (e.g., numbers of gas stations). Assault injuries were related to measures of poverty and vacant housing. All 3 outcomes were directly related to percent of female-headed households, percent African American residents, and density of off-premise alcohol outlets. CONCLUSIONS The results demonstrate that both population and environmental characteristics are significantly correlated with rates of childhood injuries. These results suggest that some environmental characteristics, in particular the presence of many off-premise alcohol outlets in neighborhoods, may reduce the overall level of guardianship of children's activities in zip code areas, resulting in harm to their children.