ArticlePloS one2016
County Poverty Concentration and Disparities in Unintentional Injury Deaths: A Fourteen-Year Analysis of 1.6 Million U.S. Fatalities.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.
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Who cites it
32 citing papers in PubMed.
- Urban-rural disparities in injury mortality in China, 2002-2021.BMC public health · 2026Article
- State Supplemental Nutrition Assistance Program Policies and Cardiovascular Mortality.JAMA network open · 2026Article
- Associations between county-level poverty and firearm injury health encounters in Maryland, USA.Public health in practice (Oxford, England) · 2026Article
- Prevalence and Risk Factors of Unintentional In-Home Injuries in Older Adults.Medicina (Kaunas, Lithuania) · 2025Article
- Factors Affecting Home Injuries in Older Adults: An Analysis Using Binary Logistic Regression.Health science reports · 2025Article
- Motor vehicle crash death rates among passenger vehicle occupants and pedestrians by county-level social vulnerability and urbanicity: the USA, 2019.Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention · 2025Article
- Prevalence of Gun Carrying and Gun Violence Victimization and Perpetration Among a Nationally Representative Sample of U.S. Youth and Young Adults.AJPM focus · 2025Article
- Prevalence of exposure to someone else's firearm violence, threats, and risky behavior among a national sample of young people in the United States.Frontiers in public health · 2025Article
- Association between social vulnerability factors and unintentional fatal injury rates - United States, 2015-2019.Journal of safety research · 2023Article
- Predictors of falls in older adults with and without dementia.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023Article
- Child Opportunity Index and Hospital Utilization in Children With Traumatic Brain Injury Admitted to the PICU.Critical care explorations · 2023Article
- Trends and Disparities in Firearm Fatalities in the United States, 1990-2021.JAMA network open · 2022Article
- Association of Neighborhood Conditions and Resources for Children With Life Expectancy at Birth in the US.JAMA network open · 2022Article
- Association of County-Level Poverty and Inequities With Firearm-Related Mortality in US Youth.JAMA pediatrics · 2022Article
- Trends and disparities in American Indian/Alaska Native unintentional injury mortality from 1999 to 2016.Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention · 2021Article
- NIH Portfolio of Unintentional Injury Research Among Racial and Ethnic Minority Children: Current Landscape and Future Opportunities.Journal of racial and ethnic health disparities · 2021Article
- Quantification of injury burden using multiple data sources: a longitudinal study.Scientific reports · 2021Article
- Shifting patterns of disparities in unintentional injury mortality rates in the United States, 1999-2016.Revista panamericana de salud publica = Pan American journal of public health · 2021Article
- Article
- Child Access Prevention Firearm Laws and Firearm Fatalities Among Children Aged 0 to 14 Years, 1991-2016.JAMA pediatrics · 2020Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Unintentional injury is the fourth leading cause of death in the United States, and mortality due to injury has risen over the past decade. The social determinants behind these rising trends have not been well documented. This study examines the relationship between county-level poverty and unintentional injury mortality in the United States from 1999-2012. Complete annual compressed mortality and population data for 1999-2012 were obtained from the National Center for Health Statistics and linked with census yearly county poverty measures. The outcomes examined were unintentional injury fatalities, overall and by six specific mechanisms: motor vehicle collisions, falls, accidental discharge of firearms, drowning, exposure to smoke or fire, and unintentional poisoning. Age-adjusted mortality rates and time trends for county poverty categories were calculated, and multivariate negative binomial regression was used to determine changes over time in both the relative risk of living in high poverty concentration areas and the population attributable fraction. Age-adjusted mortality rates for counties with > 20% poverty were 66% higher mortality in 1999 compared with counties with < 5% poverty (45.25 vs. 27.24 per 100,000; 95% CI for rate difference 15.57,20.46), and that gap widened in 2012 to 79% (44.54 vs. 24.93; 95% CI for rate difference 17.13,22.09). The relative risk of living in the highest poverty counties has increased for all injury mechanisms with the exception of accidental discharge of firearms. The population attributable fraction for all unintentional injuries rose from 0.22 (95% CI 0.13,0.30) in 1999 to 0.35 (95% CI 0.22,0.45) in 2012. This is the first study that uses comprehensive mortality data to document the associations between county poverty and injury mortality rates for the entire US population over a 14 year period. This study suggests that injury reduction interventions should focus on areas of high or increasing poverty.
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