Violent deaths in small children in northern Sweden. 
To identify causes and trends of violent deaths among children younger than 4 years in a northern region.  Retrospective analysis of medico-legal autopsy and police data.  Data from all 72 deaths from "external causes" 1977-2004, in children < 4 years from the northern half of Sweden were analysed.  The death rate was 7.1 per 100,000 children and year during the first half of the study period, and 5.2 during the second half.  Vehicle- and drowning-related deaths were halved.  Fifteen were struck by motor vehicles (in 8 cases by heavy vehicles), 14 car occupants were killed in car crashes, 12 were killed by intentional violence inflicted by an adult, and 9 each were killed by (i) carbon monoxide/smoke inhalation, (ii) asphyxiation, or (iii) drowning.  The boy:girl ratio was 1:1 in all groups, except in the groups "drowning" and "run over by motor vehicle", where boys dominated.  Medical professionals have a difficult but important task in identifying and taking action against child abuse and in promoting child safety especially in the traffic and home environments.