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Edmond D. Shenassa, ScD, Amy Stubbendick, MS and Mary Jean Brown, ScD, RN

Edmond D. Shenassa is with the Department of Community Health and the Centers for Behavioral and Preventive Medicine, Brown Medical School/Miriam Hospital, Providence, RI. Amy Stubbendick is with the Department of Biostatistics, Harvard School of Public Health, Boston, Mass. Mary Jean Brown is with the Department of Maternal and Child Health, Harvard School of Public Health.

Correspondence: Requests for reprints should be sent to Edmond D. Shenassa, ScD, Brown Medical School, Department of Community Health and Centers for Behavioral and Preventive Medicine, One Hoppin Street, Suite 500, Providence, RI 02903 (e-mail: edmond_shenassa{at}brown.edu).

Objectives. We conducted an ecologic analysis to determine whether housing characteristics mediate the associations between concentration of poverty and pediatric injury and between concentration of racial minorities and pediatric injury and whether the association between housing conditions and pediatric injury is independent of other risks.

Methods. We created a hierarchical data set by linking individual-level data for pediatric injury with census data. Effect sizes were estimated with a Poisson model.

Results. After adjustment for owner occupancy and the percentage of housing built before 1950, the association between concentration of poverty and pediatric injury was attenuated. For concentration of racial minorities, only percentage of owner occupancy had some mediating effect. In hierarchical models, housing characteristics remained independent and significant predictors of pediatric injury.

Conclusions. The association between community characteristics and pediatric injury is partially mediated by housing conditions. Risk of pediatric injury associated with housing conditions is independent of other risks.

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