KEY FINDINGS

• Injury is the leading cause of death among children (except infants under one year) and adolescents both nationwide and in Arizona. Injury surpasses all major diseases as the cause of premature mortality among preschoolers 1-4 years old, children 5-9 years old, children aged 10-14 and adolescents 15-19 years of age (Table 1).
• Between 1987 and 1997 injuries caused seven out of every ten deaths (69.1 percent, or 4,415 fatal injuries among 6,385 total deaths of Arizonans 1-19 years old. Unintentional injuries accounted for 2 times as many deaths, as homicides and suicides combined (Figure 1).
• During 1997, Arizona children and adolescents have been at greater risk for injury deaths compared to their national peers (Figure 2, Table 3). Compared to the national rates of injury mortality, the 1997 injury death rates were 46 percent higher for Arizona children under five, 31.5 percent higher for children five to nine years old, 43.2 percent higher for children 10-14 years old, and 32.6 percent higher for adolescents 15-19 years old.
• Compared to the average annual rate of injury mortality between 1980 and 1989, the 1997 death rates for injuries were lower for Arizona preschoolers and children five to nine years old. In contrast, injuries claimed the lives of infants, children ten to fourteen years old, and adolescents 15-19 years old at almost identical rates in 1997 as in 1980-1989 (Figure 3, Table 1).
• Among age groups (Table 1), children 5-9 years old had the lowest 1997 rate of injury death (12.1 fatalities per 100,000 Arizona children in this age group), followed by children 10-14 years of age (18.9/100,000), preschoolers 1-4 years old (25.9/ 100,000), infants (38.4/100,000), while the rate was 6.6 times as high for adolescents 15 to 19 years of age (80/100,000) compared to children 5-9 years old.
• Motor vehicle collisions and drowning are the two major events, which lead to an unintentional injury death for children and adolescents (Figure 4, Table 4). Motor vehicle crashes fatally injured 170 Arizona infants, children and adolescents in 1997.
• Among children younger than 15 years old who were victims of vehicular injuries in 1997 six out of ten were occupants of motor vehicles (49 out of 84 fatalities, Table 12 and Table 13, Table 14, Table 15, Table 16), three out of ten were pedestrians and one out of ten was riding a bicycle. Among adolescent motor vehicle fatalities, six out of ten were passengers in motor vehicles (69 out of 114, Table 12 and Table 17), three out of ten were driving a car or a motorcycle (28 among 86 and one out of ten were either a pedestrian (7 fatalities) or riding a bicycle (3 fatalities). Unintentional injuries not related to motor vehicles accounted for 24.6 percent of the total mortality of adolescents in 1997.
• The third leading event responsible for an unintentional injury death differed according to age group (Table 4). In Arizona, in the eleven-year period from 1987 to 1997, it was suffocation (aspiration of food or other foreign object or mechanical suffocation) among infants and children 5 to 9 years old, burning by fire among preschoolers one to four years old, firearms among children 10 to 14 years old, and drug misuse among adolescents 15-19 years old.
• American Indian adolescents and Black infants and children had the highest rates of injury death among ethnic groups in 1997. (Figure 5, Figure 6, Figure 7, Table 20). Black infants in Arizona in 1997 were 15 times more likely than Hispanics to be victims of a fatal injury (Figure 5, Table 20). Injuries claimed the lives of Black children 1-14 years old in 1997 at a rate exceeding by at least 58 percent the rates of Hispanics and non-Hispanic whites (Figure 6, Table 20). Compared to non-Hispanic whites, the 1997 injury mortality rate was 2.6 times greater among American Indian adolescents 15-19 years old (Figure 7, Table 20).
• The homicide rate among teenagers 15-19 years old decreased for the second consecutive year from 33.4/100,000 in 1995 to 23.7/100,000 in 1997 (Figure 8, Table 1). Despite this decline, the 1997 homicide rate was 2.3 times higher than the average annual rate calculated for 1980-1989. Fifty-one of these fatalities in 1997 were attributed to firearms, 5 times as many as in 1987. During 1997, Black adolescents were 8.3 times more likely than non-Hispanic whites to be mur-dered (63.1/100,000 vs. 7.6/100,000; Table 20).
• The rate of suicide fatalities among adolescents 15-19 years old increased from 18.2/100,000 in 1996 to 19/100,000 in 1997 (Figure 8, Table 1). During 1997, American Indian teenagers were 2 times more likely than non-Hispanic whites to end their own lives (39.1/100,000 vs. 19.3/100,000; Table 20).
• In four Arizona Counties - Mohave, Yuma, Navajo and Apache - the rates of death from unintentional injuries exceeded in 1997 the statewide average of 15/100,000 by at least 25 percent (Figure 9, Table 19). There were no deaths of children aged 1-14 years in 1997 in La Paz, Gila and Greenlee counties.
• In La Paz, Greenlee, Navajo, Apache and Coconino counties, the death rates from unintentional injuries for adolescents 15-19 years old in 1997 exceeded the respective statewide rate by at least 100 percent (Figure 10, Table 19).
• From 1987 to 1997, among 2,176 fatally injured infants and children under 15 years, 286 (13.2 percent) were victims of neglect, maltreatment or murder (Figure 11, Table 18).