Research and Links

Injuries (see data for this topic)

Websites with Related Information

• California Coalition for Children's Safety and Health
• California Dept. of Public Health: Injury and Violence Prevention Branch
• California Dept. of Social Services: Office of Child Abuse Prevention
• Child Safety and Injury Prevention: Professional Resource Brief. Maternal and Child Health Digital Library.
• Child Welfare Information Gateway. U.S. Dept. of Health and Human Services, Children’s Bureau.
• Children’s Safety Network. Education Development Center.
• Cornell Research Program for Self-Injury Recovery: Self-Injury and Recovery Resources
• National Center for Injury Prevention and Control. Centers for Disease Control and Prevention.
• Prevention Institute
• Safe Kids Worldwide
• Safe States Alliance
• VetoViolence. Centers for Disease Control and Prevention.

Key Reports and Research

• Defining the Full Spectrum of Pediatric Firearm Injury and Death in the United States: It Is Even Worse Than We Think. (2023). Annals of Surgery. Naik-Mathuria, B. J., et al.
• Emergency Department Visits for Firearm Injuries Before and During the COVID-19 Pandemic — United States, January 2019–December 2022. (2023). Morbidity and Mortality Weekly Report. Zwald, M. L., et al.
• Essentials for Childhood: Creating Safe, Stable, Nurturing Relationships and Environments for All Children. Centers for Disease Control and Prevention.
• Evidence-Based Strategies and Readings in Five Injury Topics. (2017). Children's Safety Network.
• Firearm-Related Injuries and Deaths in Children and Youth: Injury Prevention and Harm Reduction. (2022). Pediatrics. Lee, L. K., et al.
• Health Plan Approaches to Child Injury Prevention. National Institute for Health Care Management Foundation & Education Development Center. Santoro, K. L., & Schmidt, E. R.
• National Parent Survey on Childhood Injury. (2022). Safe Kids Worldwide.
• Prevalence of Childhood Exposure to Violence, Crime, and Abuse: Results from the National Survey of Children’s Exposure to Violence. (2015). JAMA Pediatrics. Finkelhor, D., et al.
• Preventing Violence in California (Volume 1): The Role of Public Health. (2017). California Dept. of Public Health.
• Preventing Violence: A Review of Research, Evaluation, Gaps, and Opportunities. (2015). Futures Without Violence & Child Trends. Moore, K., et al.
• Preventing Youth Violence. (2022). Centers for Disease Control and Prevention.
• Prevention of Unintentional Childhood Injury. (2020). American Family Physician. DeGeorge, K. C., et al.
• Protecting Children in Your Home. (2015). Safe Kids Worldwide.
• Self-Injury – A General Information Guide. (2018). Self-Injury Outreach and Support.
• The Epidemiology of Unintentional and Violence-Related Injury Morbidity and Mortality Among Children and Adolescents in the United States. (2018). International Journal of Environmental Research and Public Health. Ballesteros, M. F., et al.
• The Impact of Injury: The Experiences of Children and Families After a Child’s Traumatic Injury. (2020). Clinical Rehabilitation. Jones, S., et al.

County/Regional Reports

• Key Indicators of Health by Service Planning Area. (2017). Los Angeles County Dept. of Public Health.
• Live Well San Diego Report Card on Children, Families, and Community. The Children’s Initiative.
• Pathway to Progress: Indicators of Young Child Well-Being in Los Angeles County. First 5 LA.
• Santa Clara County Public Health Department: Open Data Portal

More Data Sources For Injuries

• EpiCenter: California Injury Data Online. California Dept. of Public Health.
• FastStats: Injuries. National Center for Health Statistics.
• Health, United States – Data Finder. National Center for Health Statistics.
• Web-Based Injury Statistics Query and Reporting System (WISQARS) Centers for Disease Control and Prevention.
• Youth Risk Behavior Surveillance System (YRBSS). Centers for Disease Control and Prevention.

Learn More About This Topic

Why This Topic Is Important

More than 8 million children and youth are treated for non-fatal injuries in U.S. emergency rooms each year, and more than 200,000 require hospitalization (1, 2). For some, injuries can lead to chronic pain, permanent disability, depression, and decreased ability to participate in educational and social activities (1). Family members often must care for an injured child, which can cause stress and lost income (1). Considering medical and other expenses, work loss, and reduced quality of life, unintentional injuries among children in the U.S. cost more than $200 billion annually (1).

Intentional injuries, such as assault or self-inflected harm, though less common than unintentional injuries, still are among the leading causes of non-fatal injury hospitalization among children and youth ages 0-19, statewide and nationally (2, 3).

Firearm injuries, which may be intentional or unintentional, disproportionately affect young people. In 2014, California youth ages 15-24 represented less than 15% of the state's population but accounted for more than 40% of all non-fatal firearm-related injuries (3).

For more information on injuries, see kidsdata.org’s Research & Links section.

Sources for this narrative:

1.  Centers for Disease Control and Prevention. (2012). National action plan for child injury prevention. Retrieved from: https://www.cdc.gov/safechild/nap

2.  Centers for Disease Control and Prevention. (n.d.). WISQARS: Injury data. Retrieved from: https://www.cdc.gov/injury/wisqars/nonfatal.html

3.  California Department of Public Health. (n.d.). EpiCenter: California injury data online. Retrieved from: http://epicenter.cdph.ca.gov

Policy Implications

Injuries among children and youth are a serious and costly public health concern. Most unintentional injuries are predictable and preventable, and many can be addressed by policies and programs focused on safety (1). Intentional injuries, often occurring as a result of violence, also can be prevented through multi-level approaches directed towards individuals, families, schools, and communities (2, 3).

Policy and program options that could reduce injuries among young people include:

• Supporting research-based, cross-sector strategies to promote positive emotional health for children and parents, including routine and accessible mental health screening and services (4)
• Preventing child maltreatment by ensuring that children have safe, stable, and caring relationships with parents and caregivers, e.g., by supporting evidence-based efforts that provide caregivers with information, training, and support, such as home-visiting programs and hospital-based education programs for new mothers (5)
• Educating families on injury prevention related to the accidental exposure to medications—the leading cause of child poisoning—and other risks at home, such as bathtubs, stoves, windows, and firearms (6, 7)
• Promoting school policies that foster a positive school climate—where students feel safe, connected, and supported at school—which is associated with lower levels of student violence and high-risk behavior, including substance use (8)
• Offering youth alternatives to violence while fostering connections to caring adults through community-based education, outreach, and mentoring (3, 9)
• Strengthening, enforcing, and promoting awareness of motor vehicle safety laws, including those concerning car seats, seat belts, Graduated Driver Licensing systems, and drunk or distracted driving (10)
• Addressing family poverty, low parent education levels, neighborhood economic distress, and other social risk factors associated with child injury and maltreatment (1, 5)
• Expanding public health surveillance and targeted research into the prevalence, predictors, and consequences of youth gun violence (3, 7)

For more information about injury prevention, see kidsdata.org’s Research & Links section. Also see Policy Implications on kidsdata.org under Child Abuse and Neglect, Childhood Adversity and Resilience, Children's Emotional Health, and Youth Suicide and Self-Inflicted Injury.

Sources for this narrative:

1.  Centers for Disease Control and Prevention. (2012). National action plan for child injury prevention. Retrieved from: https://www.cdc.gov/safechild/nap

2.  Moore, K. A., et al. (2015). Preventing violence: Understanding and addressing determinants of youth violence in the United States. Child Trends & Futures Without Violence. Retrieved from: https://www.childtrends.org/publications/preventing-violence

3.  Office of Juvenile Justice and Delinquency Prevention. (2016). Gun violence and youth. U.S. Department of Justice. Retrieved from: https://www.ojjdp.gov/mpg/litreviews/gun-violence-and-youth.pdf

4.  Murphey, D., et al. (2014). Are the children well? A model and recommendations for promoting the mental wellness of the nation's young people. Child Trends & Robert Wood Johnson Foundation. Retrieved from: https://www.childtrends.org/publications/are-the-children-well-a-model-and-recommendations-for-promoting-the-mental-wellness-of-the-nations-young-people

5.  Centers for Disease Control and Prevention. (n.d.). Preventing child maltreatment through the promotion of safe, stable, nurturing relationships between children and caregivers. Retrieved from: https://www.cdc.gov/ViolencePrevention/pdf/CM_Strategic_Direction--Long-a.pdf

6.  Safe Kids Worldwide. (2015). Protecting children in your home. Retrieved from: https://www.safekids.org/research-report/report-nation-protecting-children-your-home-february-2015

7.  Safe States Alliance. (2019). Policy recommendations to prevent firearm related injuries and violence. Retrieved from: https://cdn.ymaws.com/www.safestates.org/resource/resmgr/policy/SSA_Firearm_Policy_Statement.pdf

7.  Morgan, E., et al. (2014). The school discipline consensus report: Strategies from the field to keep students engaged in school and out of the juvenile justice system. Council of State Governments Justice Center. Retrieved from: https://csgjusticecenter.org/publications/school-discipline

8.  Centers for Disease Control and Prevention. (n.d.). Preventing suicide through connectedness. Retrieved from: https://www.cdc.gov/violenceprevention/pdf/asap_suicide_issue3-a.pdf

9.  Centers for Disease Control and Prevention. (2021). Transportation safety. Retrieved from: https://www.cdc.gov/transportationsafety

How Children Are Faring

The rate of injury hospitalization among California young people ages 20 and under was 214 per 100,000 in 2015, down from 484 per 100,000 in 1991—a difference that amounts to more than 23,000 fewer discharges for non-fatal injuries statewide. Across counties with data in 2013-2015, injury hospitalization rates ranged from 133 (San Luis Obispo) to 347 (Tuolumne) per 100,000.

Between 1991 and 2015, statewide discharge rates for unintentional injuries, which account for a majority of injury hospitalizations among children and youth ages 0-20, also dropped by more than 50% overall and in all age groups but infants ages under age 1, whose rates fell less than 20%. In 1991 infants had the second lowest rate of discharge for unintentional injuries among age groups (298 per 100,000), whereas by 2012 they had the highest (249 per 100,000). By contrast, rates of discharge for intentional injuries consistently are highest among youth ages 16-20 (108 per 100,000 in 2015), followed by children ages 13-15 (80 per 100,000 in 2015).

In 2015, non-fatal firearm injuries accounted for 1,313 hospital discharges among California children and young adults ages 24 and under (9.7 per 100,000), down from 5,040 (43 per 100,000) in 1991. In 2015, boys and young men were discharged for firearm injuries at more than eight times the rate of girls and young women (17 vs. 2.1 per 100,000), and the rate of discharge among African American/black youth (49.4 per 100,000) was more than four times higher than Hispanic/Latino youth, more than 15 times higher than white youth, and more than 30 times higher than Asian/Pacific Islander youth. Across demographic groups, the most common intent of firearm-related injury is assault.