Abstract: Childhood Predictors of Unnatural Death Among a Cohort of Baltimore Young Adults: The Importance of Neighborhood, Peers, and Trauma (Society for Prevention Research 26th Annual Meeting)

Schedule:

Wednesday, May 30, 2018

Columbia A/B (Hyatt Regency Washington, Washington, DC)

* noted as presenting author

Kimberly B Roth, MHS, Doctoral Candidate, The Johns Hopkins University, Baltimore, MD

Holly C. Wilcox, PhD, Associate Professor, Johns Hopkins University, Baltimore, MD

Carla Storr, ScD, Professor, University of Maryland School of Nursing, Baltimore, MD

William W Eaton, PhD, Professor, The Johns Hopkins University, Baltimore, MD

Introduction

Unintentional injury, suicide and homicide remain the three leading causes of death among adolescents and young adults in the United States despite current preventive strategies. Few studies have examined early childhood risk factors for unnatural death among urban community-residing young adults. The present study aims to describe early and middle childhood correlates of death due to unnatural causes by age 30 years.

Methods

Data are from a longitudinal study that enrolled 2,311 children as they entered first grade in the Baltimore City Public School System in the mid-1980s. The present study included the 2,180 individuals from the original cohort with early childhood data. Cox proportional hazards survival models assessed the risk of death due to unnatural causes for multiple early childhood factors, including sociodemographics, family and neighborhood characteristics, teacher ratings of child behavior, anxiety and depressive symptoms, and experiences of violence and sexual assault. Associations with deviant peers and substance use in middle school were also assessed. Death was ascertained via National Death Index records through 2010 when the cohort was approximately 30-32 years old.

Results

Participants contributed 53,380 person-years and 85 (4%) deaths, 71 of which were due to unnatural causes (47 homicides, 4 suicides, 15 accidents and 5 overdoses). Median age of death was 23.1 years (IQR: 19.2-26.7). The deceased were mostly male (85%), black (80%), and had received free or reduced lunch in first grade (72%). In the final model, females were much less likely to die from unnatural causes (Hazard Ratio [HR]= 0.1; 95% CI: 0.06-0.2, p<0.001). Other factors increasing the hazard of unnatural death were living in an area with more public assistance housing (HR=2.3; 95% CI: 1.1-4.7, p=0.022), exposure to assaultive trauma (HR=2.5; 95% CI: 1.1-5.5, p=0.024), and association with deviant peers (HR=2.2; 95% CI: 1.3-3.7, p=0.006).

Conclusions

Neighborhood characteristics, peer associations and experiencing assaultive trauma increased the hazard of death due to unnatural causes. Identifying malleable factors associated with unnatural death could inform public health approaches to reduce health disparities in urban communities.

Abstract: Childhood Predictors of Unnatural Death Among a Cohort of Baltimore Young Adults: The Importance of Neighborhood, Peers, and Trauma (Society for Prevention Research 26th Annual Meeting)

229 Childhood Predictors of Unnatural Death Among a Cohort of Baltimore Young Adults: The Importance of Neighborhood, Peers, and Trauma