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129 Urban environments and child and adolescent injury deaths in Latin American Cities
  1. Alex Quistberg1,
  2. Ana Ortigoza1,
  3. Marcio Alazraqui2,
  4. Philipp Hessel3,
  5. Francisco Diez-Canseco4,
  6. Amelia Augusta de Lima Friche5,
  7. Ariela Braverman Bronstein1,
  8. Desiree Vidaña Perez6,
  9. Waleska Texeira Caiaffa5,
  10. J Jaime Miranda4
  1. 1Drexel University, Philadelphia, United States
  2. 2Universidad de LANUS, Lanus, Argentina
  3. 3Universidad de los Andes, Bogota, Colombia
  4. 4Universidad Peruana Cayetano Heredia, Lima, Peru
  5. 5Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
  6. 6Instituto Nacional de Salud Publica, Mexico City, Mexico


Background Urban environment impacts on child injury deaths are not well understood in low and middle-income cities.

Methods Vital registration ICD-10 codes identified 179,432 child injury deaths (2010–2016) in 366 Latin American cities of ≥100,000 population (SALURBAL City-level exposures included population (e.g., population density), landscape (e.g., isolation), street design (e.g., intersection density), and social environment (e.g., education, utility connections). Associations were estimated in multilevel negative binomial models (robust variance, population offset) by age-sex groups (<1, 1–4, 5–9, 10–14, 15–19 years) and injury type (transport, non-transport unintentional, suicide, homicide) comparing high to low standardized exposure values.

Results The most frequent child injury deaths were firearm homicides (N=63,296); by age: unintentional suffocation (<1 years), drowning (1–4 years), transport (5–9 years, 10–14 years), and firearm homicide (15–19 years). Child injury death rate types were 5% lower in cities with higher proportion of household water/sewage connections, 10% lower in cities with higher intersection density. Rates were higher in cities with higher isolated urban development. Transport deaths were 15% lower in cities with higher population density, homicide rates were 16% lower in cities with more greenspace, non-transport unintentional death rates were 3% higher in cities with bodies of water, and suicides were 31% lower in cities with higher female secondary education completion.

Conclusion Cities with more sustainable development and favorable socioeconomic characteristics may create safer environments for urban children.

Learning Outcomes 1) City-level urban environment characteristics are important determinants of children’s injury death risk; 2) Sustainable city policies can help prevent child injury deaths.

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