June 2013

Document Type


Degree Name



Dept. of Public Health and Preventive Medicine


Oregon Health & Science University


Context: Falls account for a disproportionate number of nonfatal injuries in the pediatric population. In 2005, 2.6 million fall injuries in children ages 0-19 were reported to emergency departments, with an associated medical cost of over $6 billion. Research of fall injuries has traditionally focused on individual factors. Recent research into injury has shown associations with environmental factors such as higher rates of poverty and smaller household size. Objective: To identify characteristics of the environment associated with pediatric fall injury within a fire district of Oregon. Study Population: Children ages 0-17 years utilizing the emergency medical services (EMS) system within Clackamas County Fire District #1 (CCFD1), Oregon, for 2009 – 2012. Methods: This case-control study included 562 children age 17 and under who used EMS to report either a fall injury or medical illness. Predictor variables were selected from individual and census tract-level characteristics, with location of injury as the predictor of interest. Location of injury was categorized as either residential or non-residential. A multivariate logistic model was used to characterize the association between fall injuries and location of injury. Results: Pediatric fall injuries had a significantly decreased odds of occurring at residential locations (OR = 0.26, 95% CI: 0.17 – 0.39) compared to non-residential locations. Census tracts with higher percentages of single mother families and those located further eastward were associated with increased rates of pediatric fall injury. Conclusions: The results of this study suggest that environmental factors may have an effect on the likelihood of pediatric falls. Non-residential locations, single mother families and eastward location within CCFD1 are all associated with pediatric falls. From these data, targeted interventions may be developed to reduce the risk and degree of pediatric fall injuries.




School of Medicine



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