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Am J Public Health. 2000 January; 90(1): 70–77.
PMCID: PMC1446109

Socioeconomic status and the occurrence of fatal and nonfatal injury in the United States.


OBJECTIVES: This study examined the contribution of socioeconomic status (SES) to the risk of injury mortality and morbidity among working-age adults. METHODS: The sample consisted of respondents to the National Health Interview Survey (1987-1994), and separate analyses were conducted for injury deaths to respondents by linking to the National Death Index. Proportional hazards regression models were used to analyze mortality. Logistic regression models were used to analyze morbidity. RESULTS: The effects of SES varied substantially by cause of injury mortality and indicator of SES. In the multivariate models, blue-collar workers were at significantly increased odds of nonfatal injury. Education was unrelated to total injury morbidity, although associations were observed after stratification of the outcome by severity and place of occurrence. Black persons were at increased risk for homicide, and Black and Hispanic persons were at decreased risk for suicide and nonfatal injuries, after adjustment for SES. CONCLUSIONS: SES is an important determinant of injury, although the effect depends on the indicator of SES and the cause and severity of injury.

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Selected References

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  • Scheidt PC, Harel Y, Trumble AC, Jones DH, Overpeck MD, Bijur PE. The epidemiology of nonfatal injuries among US children and youth. Am J Public Health. 1995 Jul;85(7):932–938. [PMC free article] [PubMed]
  • Link BG, Phelan J. Social conditions as fundamental causes of disease. J Health Soc Behav. 1995;Spec No:80–94. [PubMed]
  • Cummings P, Koepsell TD, Mueller BA. Methodological challenges in injury epidemiology and injury prevention research. Annu Rev Public Health. 1995;16:381–400. [PubMed]
  • Mare RD. Socioeconomic effects on child mortality in the United States. Am J Public Health. 1982 Jun;72(6):539–547. [PMC free article] [PubMed]
  • Singh GK, Yu SM. Trends and differentials in adolescent and young adult mortality in the United States, 1950 through 1993. Am J Public Health. 1996 Apr;86(4):560–564. [PMC free article] [PubMed]
  • Singh GK, Yu SM. US childhood mortality, 1950 through 1993: Trends and socioeconomic diffferentials. Am J Public Health. 1996 Apr;86(4):505–512. [PMC free article] [PubMed]
  • Baker SP, Samkoff JS, Fisher RS, Van Buren CB. Fatal occupational injuries. JAMA. 1982 Aug 13;248(6):692–697. [PubMed]
  • Loomis DP. Occupation, industry, and fatal motor vehicle crashes in 20 states, 1986-1987. Am J Public Health. 1991 Jun;81(6):733–735. [PMC free article] [PubMed]
  • Feinstein JS. The relationship between socioeconomic status and health: a review of the literature. Milbank Q. 1993;71(2):279–322. [PubMed]
  • Wagener DK, Winn DW. Injuries in working populations: black-white differences. Am J Public Health. 1991 Nov;81(11):1408–1414. [PMC free article] [PubMed]
  • Onwuachi-Saunders C, Hawkins DF. Black-white differences in injury. Race or social class? Ann Epidemiol. 1993 Mar;3(2):150–153. [PubMed]
  • Lacqua MJ, Sahdev P. The epidemic of penetrating trauma: a national dilemma. J Emerg Med. 1993 Nov-Dec;11(6):747–752. [PubMed]
  • Centerwall BS. Race, socioeconomic status, and domestic homicide, Atlanta, 1971-72. Am J Public Health. 1984 Aug;74(8):813–815. [PMC free article] [PubMed]
  • Robinson JC. Racial inequality and the probability of occupation-related injury or illness. Milbank Mem Fund Q Health Soc. 1984 Fall;62(4):567–590. [PubMed]
  • Patterson BH, Bilgrad R. Use of the National Death Index in cancer studies. J Natl Cancer Inst. 1986 Oct;77(4):877–881. [PubMed]
  • Liberatos P, Link BG, Kelsey JL. The measurement of social class in epidemiology. Epidemiol Rev. 1988;10:87–121. [PubMed]
  • Abramson JH, Gofin R, Habib J, Pridan H, Gofin J. Indicators of social class. A comparative appraisal of measures for use in epidemiological studies. Soc Sci Med. 1982;16(20):1739–1746. [PubMed]
  • Liao Y, Cooper RS, Cao G, Durazo-Arvizu R, Kaufman JS, Luke A, McGee DL. Mortality patterns among adult Hispanics: findings from the NHIS, 1986 to 1990. Am J Public Health. 1998 Feb;88(2):227–232. [PMC free article] [PubMed]
  • Kellermann AL, Rivara FP, Somes G, Reay DT, Francisco J, Banton JG, Prodzinski J, Fligner C, Hackman BB. Suicide in the home in relation to gun ownership. N Engl J Med. 1992 Aug 13;327(7):467–472. [PubMed]
  • Kogan MD, Overpeck MD, Fingerhut LA. Medically attended nonfatal injuries among preschool-age children: national estimates. Am J Prev Med. 1995 Mar-Apr;11(2):99–104. [PubMed]
  • Rosenberg ML, Davidson LE, Smith JC, Berman AL, Buzbee H, Gantner G, Gay GA, Moore-Lewis B, Mills DH, Murray D, et al. Operational criteria for the determination of suicide. J Forensic Sci. 1988 Nov;33(6):1445–1456. [PubMed]
  • Jobes DA, Berman AL, Josselson AR. Improving the validity and reliability of medical-legal certifications of suicide. Suicide Life Threat Behav. 1987 Winter;17(4):310–325. [PubMed]
  • Pearce N. Traditional epidemiology, modern epidemiology, and public health. Am J Public Health. 1996 May;86(5):678–683. [PMC free article] [PubMed]

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