Social inequalities in unintentional childhood injury incidence suggest subgroup identification and differentiation in the municipal planning of preventive efforts

Abstract

Aims: This registry-based study examined differences according to socio-economic factors in the incidence of unintentional childhood injuries involving main injury types. Methods: All children aged 0–15 years living in the municipality of Odense were followed from January 1 2006 to December 31 2010 ( n=176,585). Injury outcome ( n=27,745) was defined as visits to the local emergency department. Cohort data were transferred to Statistics Denmark and linked with socio-economic registry data based on unique personal identification numbers. Results: Children aged 10–15 years were at the highest risk for any injury (incidence rate ratio (IRR)=1.14), traffic injury (IRR=5.89) and sports injury (IRR=49.58) compared to children aged 0–4 years. Girls were at lower risk for any injury (IRR=0.85) and higher risk for sports injury (IRR=1.11) and home injuries (IRR=1.12) compared to boys. Children of parents with the lowest household income were at the highest risk for any injury (IRR=1.19) and traffic injury (IRR=2.16) compared to children of parents with the highest group. Children of parents with primary education were at the highest risk of any injury (IRR=1.22) and the lowest risk of traffic injury (IRR=0.80) and sports injury (IRR=0.75) compared to children of parents with tertiary education. Immigrants and descendants were at lower risk for any injury (IRR=0.75 and 0.79, respectively) and sports injury (IRR=0.81 and 0.68, respectively) compared to Danish children. Conclusions: Injury risk varied with socio-economic factors in a Danish municipal setting. The effect varied between specific injury types. Social and ethnic background is important in establishing targeted preventive efforts, but some aspects of selection bias may occur.

Health care utilisation for treatment of injuries among immigrants in Norway: a nationwide register linkage study

“…Consistent with past research (Schwebel et al 2005;Xiang et al 2007;Laursen and Moller 2009;Sandvik et al 2012;Norredam et al 2013;Karimi et al 2015;Saunders et al 2017;Chang and Miller 2018;Andersen and Lauritsen 2020;Aamodt et al 2020), we found that most immigrant groups had lower injury incidence than the non-immigrant population. One possible explanation for this finding is the so-called "healthy migrant effect", which postulates that the arduous process of migration selects for better health amongst migrants than the average of both the population they leave behind and the population they enter (McDonald and Kennedy 2004).…”

“…Injuries remain a major public health challenge, being a leading cause of death for young people worldwide and placing a substantial burden on health care services (Polinder et al 2012 ; Global Burden of Disease Study 2013 Collaborators 2015 ; Haagsma et al 2016 ; World Health Organisation 2014 ; Polinder et al 2016 ). Research in developed countries comparing injury risk between immigrants and their native-born counterparts has generally found lower incidence rates in immigrant populations (Schwebel et al 2005 ; Xiang et al 2007 ; Laursen and Moller 2009 ; Sandvik et al 2012 ; Norredam et al 2013 ; Karimi et al 2015 ; Saunders et al 2017 ; Chang and Miller 2018 ; Andersen and Lauritsen 2020 ; Aamodt et al 2020 ). This advantage occurs despite the presence of various risk factors that ordinarily correlate with worse health outcomes, like lower socioeconomic position (Mackenbach et al 2008 ).…”