ANTHOLOGY

Fire Fatalities and Poverty

DAVID HEMENWAY Harvard School of Public Health

Injury is a major public health problem in the United States. Americans aged 1-35 die more often from injury than from disease. Fire is the fourth leading cause of uninten- tional injury death in the U.S., behind only motor vehicles, fall, and drowning fatalities. The U.S. and Canada have the highest fire fatality rates in the developed world.

Three variables--cigarettes, alcohol, and poverty--are associated with many public health problems. Cigarettes and alcohol are also important factors in U.S. fire fatalities. Smoking is the leading cause of fire death; cigarettes are the ignition source in roughly 25-30 percent of all fire fatalities. Alcohol consumption is probably associated with ignition; it is definitely related to victimiza- tion. A study in Maryland found that one third of adult fire victims met the legal definition of intoxication. The present paper presents some evidence on the relationship between poverty and fire death.

Fairly reliable data are available on the fire fatality rates in states and large cities. Most of the states with the highest fire fatality rates are located in the Deep South. An analysis of cross-sectional data from the early 1980's shows that poverty rates are highly correlated with state fire fatality rates. Indeed, a single variable--the percent of the state population below the poverty line-- explains over 50 percent of the variation in fire death rates among the 48 contiguous states. Average income per capita is not as good a predictor of fire fatality. Three

factors highly correlated with poverty--the percent of the population that is non-white, the percent living in rural areas, and the non- fire state death rate----explain over 75 percent of the variation. These independent variables describe the likely victims of fire. Those with a high risk of fire fatality are Blacks, rural residents, and people at high risk of death from other causes, such as the aged and the physically and mentally impaired.

Large cities, like rural areas, have high fire death rates. Data from the 57 largest cities in the mid-1970's show that those cities with the highest fire fatalities per capita were all located east of the Mississippi River. Western cities had the lowest fire death rates. Poverty was again associated with fire fatality rates, and was a better predictor than per capita income. The best explanatory variable was city population change. Grow- ing cities had relatively few fire deaths. Population change is correlated with a number of housing variables, such as age of the housing stock and dilapidated condi- tions. Poverty and populat ion change explained over 50 percent of the variation in city fire fatality rates.

This state and city evidence suggests that poverty is a major determinant of fire fatalities. The finding is consistent with data from a number of small areas studies. Further investigation is required to deter- mine the precise reasons for the poverty-fire fatality connection.