2014.ISDS.Abstracts.Final.pdf


ISDS Annual Conference Proceedings 2014. This is an Open Access article distributed under the terms of the Creative Commons Attribution-
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ISDS 2014 Conference Abstracts

Childhood Injury in Wake County, NC: Local Use of 
Public Health Surveillance Data
Anna E. Waller*, Steven Lippmann, Amy Ising and Carolyn Crump

UNC-Chapel Hill, Chapel Hill, NC, USA

Objective
To utilize secondary data sources to describe childhood injury and 

prioritize prevention efforts in Wake County, NC.

Introduction
A local foundation commissioned a project to determine the leading 

causes of childhood injury in Wake County, NC. Multiple sources of 
secondary data, including syndromic surveillance data, were used to 
describe leading causes of childhood injury in the county.1

Methods
Mortality (deaths) were identified in data available online through 

the NC State Center for Health Statistics (SCHS) and the NC Violent 
Death Reporting System. Hospital Discharges were identified 
through the NC SCHS hospital discharge data file and accessed by 
staff in the Injury and Violence Prevention Branch at NC Division 
of Public Health (NC DPH). Emergency Department Visits were 
identified through NC DETECT and accessed by project staff under a 
Data Use Agreement with NC DPH. Descriptive statistics and cross-
tabulations were computed using SAS version 9.2 and Microsoft 
Excel. Injury intent and mechanism were categorized based on ICD-
10 (mortality) or ICD-9-CM (ED and hospital) external cause codes. 
Rates were computed using estimates for 2010-2012 as the population 
denominators.

Results
To develop a list of the leading causes of injuries among Wake 

County children ages 0-17, we rank-ordered the top five injury 
mechanisms in each of the three data sources (Table 1) and determined 
the order of the top ten causes based on their occurring in all three, 
two, or only one of our major data sources. Motor Vehicle Crashes 
(MVC) (occupant, pedestrian, all) were one of the five leading causes 
for all three data sources, thus their placement as the 1st and 3rd leading 
injury causes. MVC-Pedestrian was kept separate as the 3rd leading 
cause given differences in prevention approaches for occupants 
versus pedestrians. Assault and Self-Inflicted/Self Harm were in the 
top five injury causes for both mortality and hospital discharges, 
thus their placement as 2nd and 4th leading causes. Falls was in the 
top injury cause for both hospital discharges and ED visits, and the 
number of fall events was significantly higher than the number of 
deaths due to Unintentional Suffocation, thus the placement of Falls 
and Suffocation as the 5th and 6th leading causes, respectively. Burns, 
Struck By/Against, Natural/Environmental Factors, and Bicycle 
Injury/Crashes were placed in the 7th through 10th positions because 
they were among the five leading injury causes for hospital discharges 
or ED visits only.

More than half the injury related hospital discharges (58.1%) 
and ED visits (58.5%) were by male children; this was true for all 
age groups. Children ages 1-4 years had the most injury ED visits, 
followed by those 10-14 years. Children ages 15-17 years had more 
injury hospitalizations than any other age group, accounting for 27.7% 
of all injury related hospital discharges. The number of injury-related 
ED visits increased steadily between 2006 and 2012. Nine out of ten 
injury-related ED visits by Wake County children resulted in being 

discharged to home (91.2%), while 4.5% resulted in being admitted 
to the hospital or transferred to another hospital. There were 29 deaths 
in hospital for injured patients (1.0%).

Conclusions
A wealth of information about childhood injury in Wake County, 

NC, was available through secondary data sources, including 
syndromic surveillance data. Timely and comprehensive ED visit 
data collected in NC DETECT proved invaluable to assessing local 
childhood injury causes. The ranking of childhood injury causes 
varied greatly between data sources, highlighting the importance 
of including a variety of data in a community health assessment. 
Including ICD-9-CM codes in a syndromic surveillance system 
enables inclusion of these data in health assessments and other 
retrospective analyses.

Keywords
Injury surveillance; Childhood Injury; Community Assessment; Local 
public health; Secondary data

Acknowledgments

The ED visit data were obtained from NC DETECT under a Data Use 
Agreement with the NC Division of Public Health. The NC DETECT Data 
Oversight Committee takes no responsibility for the scientific validity 
or accuracy of methodology, results, statistical analyses, or conclusions 
presented.

References

1. Crump C, Page R, Letourneau R, Waller A, Lippman S, Ising A
(Healthy Solutions, University of North Carolina, Chapel Hill, NC).
A Profile of Wake County Childhood Injury & Injury Prevention.
Raleigh (NC): John Rex Endowment; 2014, 102 p.

*Anna E. Waller
E-mail: awaller@med.unc.edu    

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * (1):e172, 201