Personal and family predictors of children's medically attended injuries that occurred in the home.

OBJECTIVE This study examined the independent contributions of demographic, behavioral, and environmental antecedents of pediatric medically attended injuries that occurred in the home. SETTING Two household and thirty six American children aged 4-12 in 1988 were drawn from the National Longitudinal Survey of Youth. METHOD Multiple logistic regression was used to examine whether having a medically attended injury that occurred in the home in 1990 was related to environmental, behavioral, and demographic indicators measured in 1988. To account for individual differences in access to care, results were stratified within samples of children that had, and had not, demonstrated a prior ability to access the medical care system for injury treatment. RESULTS Among children who did not access the medical care system for injury treatment in 1988, measures of home environmental risk factors did not distinguish those injured at home from those not injured at home in 1990. However, among children who did access the medical care system for injury treatment in 1988, indicators of "dark" (relative risk 4.68, p = 0.019) and "cluttered" (relative risk 4.31, p = 0.038) home environments became significantly and independently associated with home injuries in 1990. CONCLUSION If not accounted for in data collection or analyses, individual differences in non-financial barriers to medical care may read to an underestimation of the influences of important home environmental risk factors for medically attended injuries.