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EMBARGOED FOR RELEASE: MAY 6, 2004,
12:00 A.M. ET
COLUMBIA STUDY SHOWS ETHNIC DISPARITIES IN
INJURIES DUE TO FALLS
FROM BUILDINGS
New York City’s Window Guard Law
Dramatically Lowers Risks
NEW YORK, N.Y. – A
national study by Columbia University Medical Center (CUMC) researchers
shows that young minority children from lower income neighborhoods are
far more likely to die or be injured in falls from buildings. The study
also shows that in New York City injury rates are nearly half the
national average, despite the fact that a higher proportion of New
Yorkers live in multi-unit homes. Rates in New York State outside of
New York City more closely resemble the national average. The
study’s authors attribute these differences to the mandatory use of
window guards in New York City, the only major city in the United
States with a law mandating the use of window guards.
The study, conducted by researchers affiliated with CUMC’s Center
for the Health of Urban Minorities, is the first to look at ethnic
differences in building falls among children. CUMC researchers found
that Latinos have the highest overall rate of falls, followed by
African Americans and then whites. The greatest disparities exist
before age 4: Latino rates are more than double those of whites,
with African Americans close behind Latinos. The study appears in
the May 2004 issue of the journal Applied Environmental Science and
Public Health.
“These results demonstrate that the public health community must
develop new, culturally appropriate strategies to reach minority
parents,” says Barbara A. Barlow, M.D., professor of surgery, Columbia
University Medical Center and director, Department of Surgery, Harlem
Hospital. “They also demonstrate the need for window guard
legislation in urban areas, where most of the affected minority
children are injured or killed.” A noted expert on injury
prevention, Dr. Barlow is executive director of the Injury Free
Coalition for Kids, a Robert Wood Johnson Foundation-funded initiative
with 40 injury prevention sites across the U.S. that is based at
Columbia’s Mailman School of Public Health.
The study examined statewide hospital discharge data from New York
State and a national database of pediatric admissions from 27 states
that included 1,091 unintentional and 70 suicidal fall cases. The
states were Arizona, California, Colorado, Connecticut, Florida,
Georgia, Hawaii, Iowa, Kansas, Kentucky, Massachusetts, Maryland,
Maine, Missouri, North Carolina, New Jersey, New York, Oregon,
Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia,
Washington, Wisconsin, and West Virginia.
Among African Americans and Latinos, nearly half of hospitalizations
due to falls from buildings occurred in the youngest age group, 0-4
years old (48% and 46% respectively). Among whites, one in three
falls (33%) occurred in this age group. Most falls occurred at
home, but this decreased with age, from 88% in very young children to
41% in 15-18 year olds. Across ethnicities, most falls victims of any
age were male: 73% of Latinos, 71% of whites, and 66% of African
Americans. Among those injured in an intentional fall or suicide
attempt, 81% were associated with mental illness, alcohol or substance
abuse.
Window Guards Save Lives
The Columbia researchers credit window guard legislation and
enforcement in New York City, aimed at protecting children under eleven
from window falls, for dramatically reducing injury or death due to
falls. In New York City, 54% of residents live in multi-family
dwellings with 10 or more units, compared with 13% of the national
population. Forty percent of the state’s children live in New
York City. Yet the building fall rate in New York City, which includes
falls from roofs and fire escapes as well as windows, is nearly half
the national average. New York City, which has had a window guard
law in effect since 1976, is the only large city in the nation to
mandate that landlords install these safety devices. In a paper
published in 1983, Dr. Barlow found that the law and accompanying
public education campaign resulted in a 96% decrease in window falls in
Harlem. Eighty percent of building falls prior to enactment of
the law were from windows.
The New York City law requires that building owners install approved
window guards in the home of any family where a child younger than
eleven years of age lives. Owners are also responsible for installation
of window guards in public areas if a child under age eleven lives in
the building. The law also requires the building owner to send
every tenant a notification form once a year to identify new needs for
window guards. The tenant must complete and return the signed
form indicating whether or not children under eleven years of age live
in the apartment or if the tenant or occupant wants window guards for
any reason. The New York City Department of Health and Mental
Hygiene operates the Window Falls Prevention Program, which includes a
web site containing public information on the law, its enforcement, a
list of approved manufacturers of window guards, installation
instructions, and frequently asked questions. The web site can be
found at: http://www.nyc.gov/html/doh/html/win/win.html
According to the City, three preventable window falls were reported to
the Window Falls Prevention Program in 2002 (NOTE: these data
were not used in the Columbia study, which looked at building falls
overall and not window falls). “Window guard legislation, in
conjunction with public education and enforcement efforts, prevents
injuries and saves lives,” says study author Joyce Pressley, Ph.D.,
M.P.H., assistant professor of health policy and management at the
Mailman School of Public Health, Columbia University.
Falls Greatest in Warm
Weather
The study uncovered a number of seasonal variations never before
reported. Consistently strong peaks in numbers of injured have
been observed during warmer months, generally reflecting increased
falls from windows left open apparently to regulate temperatures in the
home. However, the Columbia study found that previously reported
seasonal peaks in falls from buildings appear to be age-related, with a
higher year-round risk for older children and adolescents than for
younger children. Most building-fall injuries and deaths among 0-4 year
olds occur from May to September, with a gradual increase in injuries
beginning as early as March and April. In contrast, among 15-18
year olds, injuries due to falls from buildings are more evenly
dispersed throughout the year, with injuries in February and December
exceeding those in the hot weather months of July and August.
# # #
*Located in New York City, Columbia University
Medical Center provides international leadership in basic and clinical
research, medical education, and health care. The medical center
includes the dedicated work of many physicians, scientists, and other
health professionals from the College of Physicians & Surgeons, the
School of Dental & Oral Surgery, the School of Nursing, the Mailman
School of Public Health, the biomedical departments of the Graduate
School of Arts and Sciences, and allied research centers and
institutions. Columbia University physicians and scientists achieved
some of the 20th century's most significant medical breakthroughs,
including the first blood test for cancer, the first medical use of the
laser, and the first successful transfer of genes from one cell to
another. This pioneering tradition continues today through 24
departments and several specialized research centers and institutes
acclaimed for work in neuroscience and neurology, emerging infectious
diseases, diabetes, community health, and many other areas of
expertise.
*The Columbia Center for the Health of Urban Minorities conducts and
supports research, training, education, and community partnerships
aimed at improving the health of Latinos and African-Americans in
northern Manhattan. The center is funded by the National
Institutes of Health's National Center on Minority Health and Health
Disparities.
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