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The purpose of this study is to present data on the distribution and etiology of nonfatal injuries resulting in hospital discharges in New York City (NYC). Records of all NYC residents discharged for injuries from acute stay hospitals 1990-1992 were tabulated. Injuries from surgical and medical procedures, adverse effects of drugs in therapeutic use, and late effects of injury were excluded. The results indicate that there was a marked geographic variation in rates: higher rates of assaults, self-inflicted injuries, burns, unintentional injuries from firearms, and injuries to bicyclists in disadvantaged neighborhoods. The data show that injuries in NYC have distinctive features that should form the basis for targeted prevention activities.

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OBJECTIVES: To describe the rate and distribution of injuries during basic training in male and female cadets and to assess the contribution of pretraining conditioning and height to the male-female differential in injuries. DESIGN: Cohort study. SETTING: The US Military Academy, West Point, NY. PARTICIPANTS: A total of 558 cadets from the class of 1995 at the US Military Academy. MAIN OUTCOME MEASURES: The rate of injuries resulting in 1 or more days excused from physical activities per 100 cadets and the rate of injuries resulting in hospitalization of 1 night or longer per 100 cadets. RESULTS: Women had 2.5 times the rate of injuries as men and 3.9 times the rate of injuries resulting in hospitalization. Women had significantly more stress fractures and stress reactions than men. The median number of days excused from physical activities for women's injuries was significantly higher than that from men's injuries. Pretraining conditioning, measured by performance on a 2-mile (3.2-km) run, accounted for approximately half the difference in rates of injuries between men and women; differences in height among men and women did not account for differences in injury rates. CONCLUSIONS: The women had a higher risk for injury during military training than men. Increased pretraining conditioning may substantially decrease the risk for injury.

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OBJECTIVE: Millions of US children are exposed to parents who are problem drinkers, yet there is little evidence about the effect of parental alcohol consumption on children's health. The aim of this study was to assess the association between children's injuries and parental drinking. DESIGN: Survey of a nationally representative sample of the US population by household interview. PARTICIPANTS: 12,360 children and parents from single-family households, with data from the Alcohol and Child Health supplements to the 1988 National Health Interview Survey. MAIN OUTCOME MEASURE: Serious injuries--injuries resulting in hospitalization, surgical treatment, missed school, one half day or more in bed. RESULTS: Children of mothers categorized as problem drinkers had 2.1 times the risk of serious injury as children of mothers who were nondrinkers (95% CI, 1.3 to 3.5). Other measures of mothers' alcohol consumption (ie, average, maximum, and self-rated consumption) were unrelated to child injuries, as were all measures of fathers' drinking. Children of women who were problem drinkers married to men rated as moderate or heavy drinkers had a relative risk of serious injury of 2.7 (95% CI, 0.8 to 8.6) compared with children of nondrinkers. CONCLUSION: Children of women who are problem drinkers have an elevated injury risk; children with two parents who are problem drinkers are at higher risk. Further research is needed on potential mechanisms and interventions. Primary prevention might be enhanced if physicians elicited information about parental drinking, helped secure appropriate treatment, and participated in public health efforts to reduce the deleterious effects of alcohol.

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Several studies have linked cumulative measures of stress to injuries, however none have examined the relationship between a prevalent stressor in adolescence, conflict between the parent and adolescent, and injuries. Data for this study came from 8231 British adolescents born one week in 1958 who had information on injuries between ages 15 and 17 available. A conflict scale was devised by summing mothers' assessments of the frequency of arguments with their 16-year-old offspring about eight problem areas. This scale had a linear association with injury rates for both boys and girls. Adolescent boys with high levels of conflict (greater than 90th percentile on conflict scale) had 2.9 times the rate of injuries resulting in hospitalization compared with boys from low conflict families (less than 25th percentile), and 1.6 times the number of injuries resulting in outpatient care. Girls with high levels of conflict had 2.9 times the hospitalized injuries and 1.8 times the rate of less severe injuries compared with girls with low conflict. These findings suggest that conflictual parent-adolescent relationships may be an indicator of increased injuries in adolescents.

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Prior studies investigating the relationship between infant feeding and infectious illnesses in developed countries have provided conflicting data about whether breast-feeding protects against common infectious illnesses early in life. These conflicts may in part be due to the failure to consider the following methodologic issues: (1) collecting data prospectively at frequent intervals for active surveillance of the detection of infections and of feeding practices, (2) specifying what is meant by infectious illnesses and breast-feeding, (3) controlling for confounding variables such as social class or presence of siblings in the household, and (4) applying appropriate analytical strategies to a population in which both feeding and exposure to illness change over time. A total of 500 infants born consecutively in a university-affiliated community hospital in Copenhagen, Denmark, were studied prospectively for the first 12 months of life by means of a detailed, monthly, mailed questionnaire that focused on feeding practices and illnesses (overall response rate, 73%). The percentage of infants who were completely or mostly breast-fed decreased from 88% at 1 month to 20% at 12 months of age. After adjustment for major covariates, no statistically significant relationship was found between the type of infant feeding and the incidence of four categories of infectious illnesses: gastroenteritis, upper respiratory illness, otitis media, and lower respiratory illness. The adjusted incidence density ratio for gastroenteritis was 1.067 (95% confidence interval = 0.982, 1.226) and for upper respiratory illnesses 0.984 (95% confidence interval = 0.883, 1.096).(ABSTRACT TRUNCATED AT 250 WORDS)

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The contribution of parental smoking to wheezing in children was studied in a subset of all British births between April 5 and 11, 1970 (N = 9,670). Children of smoking mothers had an 18.0 per cent cumulative incidence of post-infancy wheezing through 10 years of age, compared with 16.2 per cent among children of nonsmoking mothers (risk ratio 1.11, 95% CI: 1.02, 1.21). This difference was confined to wheezing attributed to wheezy bronchitis, of which children of smokers had 7.4 per cent, and those of nonsmokers had 5.2 per cent (risk ratio 1.44, 95% CI: 1.24, 1.68). The incidence of wheezy bronchitis increased as mothers smoked more cigarettes. After multiple logistic regression analysis was used to control for paternal smoking, social status, sex, family allergy, crowding, breast-feeding, gas cooking and heating, and bedroom dampness, the association of maternal smoking with childhood wheezy bronchitis persisted. Some of this effect was explained by maternal respiratory symptoms and maternal depression, but not by neonatal problems, the child's allergic symptoms, or paternal respiratory symptoms. There was a 14 per cent increase in childhood wheezy bronchitis when mothers smoked over four cigarettes per day, and a 49 per cent increase when mothers smoked over 14 cigarettes daily.

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The behavior of 10,394 British children was related prospectively to their injury history between ages 5 and 10 years, obtained from parents. Aggressive and overactive behaviors at age 5 years were measured by subscales of the Rutter Child Behavior Questionnaire completed by the parents. Multivariate techniques were used to assess the association between behavior and injuries while controlling for social, demographic, and psychological characteristics. Boys' behavior at age 5 years was more strongly predictive of injuries in the subsequent five years than was girls' behavior. The odds of experiencing injuries resulting in hospitalization in boys with high aggression scores was 2.4 times that of boys with low aggression scores. The identification of high-risk children provides the foundation for understanding the behavioral mechanisms that contribute to injuries and for developing preventive strategies tailored to the needs of these children.

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Recalls of monthly family food expenditure, taken before and after maternal WIC benefits, were obtained from 4,219 WIC and 785 control women; 1-wk expenditure diaries (at follow-up) were obtained from 1,031 WIC and 551 control women chosen randomly. Control families had higher incomes, spent more on groceries and in restaurants, and received fewer food stamp benefits. Women probably underreported the value of WIC benefits by recall (WIC vouchers are not dollar denominated). Although control families were more affluent, there were consistent effects of children's WIC benefits on weekly family grocery expenditure by diary ($6.10, p less than 0.05) and by recall ($2.14, p less than 0.01, and $1.48, p less than 0.05). WIC benefits to infants were associated with very large (but not significant) increments in grocery spending by diary ($7.57). WIC benefits to the pregnant woman were strongly associated with larger amounts of WIC food entering the household (as were infant and child benefits) but effects on grocery spending were unclear.

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The relationship between accidents and number of children in the household was assessed in 10,394 children surveyed at ages 5 and 10 years. The analyses suggest that living in a household with 3 or more children during the preschool period increases a child's risk of experiencing accidents that result in hospitalization; and that living in a household with 4 or more children increases the risk of such accidents to school-age children. The number of older rather than younger children had the greatest impact on accident risk. The observed odds ratios suggest that children with 4 or more siblings have 80% to 90% more injuries resulting in hospitalization than only children. The proportions of children with one or more accidents (regardless of the place of treatment) and with repeat accidents were unrelated to family size. Environmental differences between families of varying size accounted for the association with hospitalized accidents.

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