Temporal trends, gender, and geographic distributions in child and youth injury rates in Sweden.

OBJECTIVE Sweden has the lowest child injury mortality rate in the world, 5.2/100 000 for children under 15. This paper describes temporal trends in Sweden, as well as gender related and geographic differences. DESIGN The Swedish Cause-of-Death Register (1987-2001) and the Hospital Patient Register (1987-2002) were used to compare rates for the country as a whole and for discharges aged 0-20 by municipality, using the SEATS time series analysis program. RESULTS There was a decrease in the rate of fatal unintentional injuries from 7 to 4 per 100 000 for girls and from 16 to 10 per 100 000 for boys since 1987. The gap between girls and boys was reduced and boys now have almost the same mortality rate as girls for violence related deaths. Road and other unintentional injuries show a general decrease whereas the pattern for falls varies by age and sex. Self inflicted injuries increased for both sexes, but more for girls. Substantial differences in injury rates between municipalities were also found-up to six times for girls and eight times for boys. CONCLUSION Substantial declines in injury fatalities over time were found, but these were different for boys and girls. There remain substantial differences between municipalities. These data, published in a child injury atlas, have prompted substantial interest among media and the authorities.