Safe Kids

Traffic fatalities for children have declined by almost fifty percent, the newest data just crunched by the CDC and reported in Morbidity and Mortality Weekly Report (MMWR) establishes.  Good news indeed! Rick and I agree on PodMed this week.  It's always so wonderful when a somewhat tedious practice results in such a dramatic reduction in that hard endpoint of death, and especially death in children.  I say somewhat tedious because as anyone who's reading this probably already knows, kids don't much like car seats of any ilk, and are likely to protest in whichever way they can when buckled into them.  Yet the data is irrefutable and provides a compelling argument to enforce existing law and expand it further, as this paper clearly demonstrates that we have a ways to go.  Let's examine the numbers more closely.

The CDC analyzed data regarding traffic fatalities in the 0-12 year old set from 2002 through 2011.  Deaths per age category and restrained versus unrestrained were also broken out, with children younger than one year of age, one to three years of age, 4 to 7 year-olds, and 8-12 year olds comprising the categories.Data from 2009-2010 was also further stratified with regard to ethnicity, with sufficient numbers to permit reporting for non-Hispanic whites, African Americans, and Hispanics.  The age groups were used that correspond to recommended forms of restraint categories, such as infant seat or booster seat.

The good news is that during this time period, deaths in motor vehicle accidents declined by 43% for all age groups.  Per age category, motor vehicle death rates decreased significantly among children aged <1 year by 45%, 1–3 years by 44%, 4–7 years by 43%, and 8–12 years by 41%. However, of the children who died as a result of motor vehicle accidents, 33% were unrestrained.

Ethnicity was also an important factor in this analysis. Black children had a significantly higher proportion of unrestrained child deaths compared with white children for those aged 1–3 years (47% versus 20%), 4–7 years (46% versus 26%), and for all children aged 0–12 years combined (45% versus 26%).  Hispanic children also had a significantly higher proportion of unrestrained child deaths compared with white children for those aged 4–7 years (50% versus 26%), 8–12 years (55% versus 33%), and 0–12 years (46% versus 26%). As Rick opines in the podcast, this clearly points to the need for culturally sensitive education to inform black and Hispanic parents on the need to provide age-appropriate restraints for their children when they are passengers in motor vehicles.

Another issue worth consideration emerged from this analysis. Only two states in the US, Tennessee and Wyoming, have laws that mandate use of booster seats among older children until they reach the age of 8 years, although children aged 8–12 years had the highest proportion of unrestrained child deaths (45%), based on known restraint use.  Clearly this points to the need to enact laws mandating use of age and size-appropriate restraints for everyone riding in or on a motor vehicle.  As I comment to Rick in the podcast, we've had great national success with seat belt use by adults, and the same should be enacted for children of all ages.

Other topics this week include no help for slowing cognitive decline with tight control of risk conditions in people with diabetes in JAMA Internal Medicine, a new type of medication for post-herpetic neuralgia  and a novel flu virus in the Lancet.  Until next week, y'all live well.

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