Minnesota Title V MCH Needs Assessment Fact Sheets

Pregnant Women, Mothers and Infants

Prevention of Infant Unintentional Injuries

Summer 2004

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Size of the Problem

Over 68,000 births annually are recorded in Minnesota [1]. In 1990-1999, 124 infants died of unintentional injuries in their first year of life [2]. National data (based on unintentional injury hospitalization and death) estimates a rate of 337 unintentional injuries per 100,000 infants [3]. Thus, an estimated 229 Minnesota infants annually are seriously affected by unintentional injuries.

Seriousness

People affected by infant unintentional injuries.
The Healthy Minnesotans 2004 goal is deaths caused by unintentional injuries are no more than 29.3 per 100,000 population. Minnesota baseline data indicate the following [4]:

  • 1.6/100,000 children under the age of 5 years died due to unintentional injuries. (1995)
  • Infant hospitalizations due to traumatic brain injury were 117.4 per 100,000 infants (1996)

National research indicates that falls are the most common type of unintentional injury in infants [5]. However, there were different leading causes of specific injury for each 3-month segment in the first year of life. This indicates that unique risk factors, education and intervention may be needed during infancy [5]. These leading pediatric injuries by age include:

  • 0-2 months- other falls from height
  • 3-5 months- battering
  • 6-8 months- falls from furniture
  • 9-11 months- non-airway foreign body

National injury death rates identified suffocation (31.8%) as the leading cause of infant death by unintentional injury.6 Minnesota records 16-20 infant deaths annually related to unsafe sleep conditions for infants due to bedsharing with adults/other children or sleeping on adult beds or with pillows/excess bedding or on other furniture not safety-approved for infant sleep. These unintentional injury deaths are occurring in all areas of the state, among all cultures and socio-economic groups [7].

Infant Injury Prevention, Minnesota PRAMS 2002
Prevention Percent
Home has NO loaded guns, firearms
94.3%
Home has working smoke alarm
95.6%
Always/almost always rides in infant car seat
97.6%
Home from hospital in car seat
97.7%
Source: MDH. PRAMS Survey for 2002. 2004.

Minnesota’s Pregnancy Risk Assessment Monitoring System (PRAMS), 2002, surveyed new parents about home safety and injury prevention efforts to protect their infants. Results are portrayed in the table above.

Nationally, high-risk infants for injuries were more often born with the following family characteristics:

  • Mother younger than 20 years old
  • Mother had less than a high school education
  • Mother had 2 or more other children
  • Mother was unmarried
  • Infants weighed < 1500 grams at birth [6]

Disparities
National research has identified higher rates of unintentional injury among American Indian and Alaska Native children [8]. In Minnesota, unintentional injury is the third leading cause of death for the American Indian population. Over half of those deaths were motor vehicle crashes [9].

Economic
The cost-effectiveness of injury prevention has been documented. Correct use of one car seat can save $1360 in injury-related costs. Use of a smoke detector can save $900 in injury related costs. For every dollar spent on a poison control center, $6.50 of injury-related costs is saved [10].

Interventions

Specific interventions recommended:

  • The American Academy of Pediatrics (AAP) recommends infants born < 37 weeks gestation be observed for respiratory instability and secure fit in car seats [11].
  • The AAP recommends that health care providers work with the Indian Health Service, tribes and community organizations serving Native Americans to reduce higher rates of unintentional injury among Native Americans [8].
  • The Home Safety Checklist is a tool developed by MDH staff from Maternal and Child Health and the Injury and Violence Prevention Unit. Public health nurses use it statewide primarily through the Family Home Visiting program. Nurses and other home visitors provide education and intervention measures to families to prevent unintentional injuries by identifying hazards and advising families how to improve household safety for infants/children.

Effectiveness of Interventions
Studies have documented the effectiveness of prevention mechanisms and injury reduction.

Status

Minnesota Resources
Public health programs and strategies that promote infant injury prevention include:

  • Public health nurse home visiting programs to conduct home safety checks and provide education to parents.
  • Minnesota’s Department of Public Safety provides community-based and public health-based infant car seat education, distribution, and inspection.
  • Health plan car seat distribution programs
  • AAP’s TIPP (The Injury Prevention Program) sheets are distributed by providers at well baby check ups.
  • Bright Futures Family Tip Sheets, Infancy available at www.brightfutures.org/tipsheets/ [Attn: Non-MDH Link]

Community Awareness
No studies documenting community awareness of preventing infant injuries were identified.

References

1. Minnesota Center for Health Statistics. 2003
2. MDH. Ten Leading Causes of Mortality by age group, Minnesota 1990-1999. Accessed 6-04. www.health.state.mn.us/injury/pub/mort/mcauses21.htm
3. Agran PF, Anderson C, Winn D, et al. Rates of pediatric injuries by 3-month intervals for children 0 to 3 years of age. Pediatrics 111(6):683-692. 2003.
4. MDH. Healthy Minnesotans: Public Health Improvement Goals 2004. September 1998.
5. Pickett W, Streight S, et al. Injuries experienced by infant children: a population-based epidemiological analysis. Pediatrics. 111(4):365-370. 2003.
6. Scholer SJ, Hickson GB, Ray WA. Sociodemographic factors identify US infants at high risk of injury mortality. Pediatrics 103(6):1183-1188. 1999.
7. MDH. Data from MN SID Center.
8. American Academy of Pediatrics. The prevention of Unintentional Injury among American Indian and Alaska native Children: a subject review. Pediatrics. 104(6):1397-1399. 1999.
9. Community Health Profile: MN, WI, & MI Tribal Communities, Great Lakes EpiCenter Epidemiology Project 2003.
10. MDH. Population Health Assessment. Childhood Injury. Summer/Fall 2001.
11. American Academy of Pediatrics. Safe transportation of premature and low birth weight infants. Pediatrics. 97:758-760. 1996.