Unintentional injuries in children and youth from immigrant families in Ontario, Canada: a population-based cross-sectional study

Saunders, Natasha; Macpherson, Alison; Guan, Jun; Sheng, Lisa; Guttmann, Astrid

doi:10.9778/cmajo.20160099

Cited by 8 publications

(13 citation statements)

References 40 publications

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“…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).…”

Section: Discussionsupporting

confidence: 92%

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

et al. 2020

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Background Previous research has generally found lower rates of injury incidence in immigrant populations than in native-born populations. Most of this literature relies on mortality statistics or hospital data, and we know less about injuries treated in primary health care. The aim of the present study was to assess use of primary and secondary care for treatment of injuries among immigrants in Norway according to geographic origin and type of injury. Methods We conducted a nationwide register-based cohort study of all individuals aged 25–64 years who resided in Norway as of January 1st 2008. This cohort was followed through 2014 by linking sociodemographic information and injury data from primary and secondary care. We grouped immigrants into six world regions of origin and identified immigrants from the ten most frequently represented countries of origin. Six categories of injury were defined: fractures, superficial injuries, open wounds, dislocations/sprains/strains, burns and poisoning. Poisson regression models were fitted to estimate incidence rate ratios separately for injuries treated in primary and secondary care according to immigrant status, geographic origin and type of injury, with adjustment for sex, age, county of residence, marital status and socioeconomic status. Results Immigrants had a 16% lower incidence of injury in primary care than non-immigrants (adjusted IRR = 0.84, 95% CI 0.83–0.84), and a 10% lower incidence of injury in secondary care (adjusted IRR = 0.90, 95% CI 0.90–0.91). Immigrants from Asia, Africa and European countries outside EU/EEA had lower rates than non-immigrants for injuries treated in both primary and secondary care. Rates were lower in immigrants for most injury types, and in particular for fractures and poisoning. For a subset of injuries treated in secondary care, we found that immigrants had lower rates than non-immigrants for treatment of self-harm, falls, sports injuries and home injuries, but higher rates for treatment of assault, traffic injuries and occupational injuries. Conclusions Health care utilisation for treatment of injuries in primary and secondary care in Norway was lower for immigrants compared to non-immigrants. Incidence rates were especially low for immigrants originating from Asia, Africa and European countries outside EU/EEA, and for treatment of fractures, poisoning, self-harm and sports injuries.

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Section: Discussionsupporting

confidence: 92%

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

et al. 2020

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“…safe sleeping and cooking environments, car seat safety, etc.) Moreover, maternal immigrant status is associated with risk of injury in children [ 19 , 23 ]. Individuals must have been residing in Ontario with a valid Ontario Health Insurance Plan (OHIP) number between January 1 st 2011 and December 31 st , 2012.…”

Section: Methodsmentioning

confidence: 99%

“…Most injuries are preventable, and injury reduction strategies, when targeted and implemented appropriately, are successful [ 14 – 16 ]. Immigrants have a lower risk of unintentional injury than Canadian born children [ 17 – 19 ]. Though there is some cause-specific variability, this has been demonstrated across all causes of injury [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

“…Immigrants have a lower risk of unintentional injury than Canadian born children [ 17 – 19 ]. Though there is some cause-specific variability, this has been demonstrated across all causes of injury [ 19 ]. The evidence for the extent to which the lower risk of injury persists with increasing duration of residence in a new country for children and young adults from immigrant families is not known.…”

Section: Introductionmentioning

confidence: 99%

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The shrinking health advantage: unintentional injuries among children and youth from immigrant families

et al. 2017

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BackgroundImmigrants typically arrive in good health. This health benefit can decline as immigrants adopt behaviours similar to native-born populations. Risk of injury is low in immigrants but it is not known whether this changes with increasing time since migration. We sought to examine the association between duration of residence in Canada and risk of unintentional injury.MethodsPopulation-based cross-sectional study of children and youth 0 to 24 years in Ontario, Canada (2011-2012), using linked health and administrative databases. The main exposure was duration of Canadian residence (recent: 0–5 years, intermediate: 6–10 years, long-term: >10 years). The main outcome measure was unintentional injuries. Cause-specific injury risk by duration of residence was also evaluated. Poisson regression models estimated rate ratios (RR) for injuries.Results999951 immigrants were included with 24.2% recent and 26.4% intermediate immigrants. The annual crude injury rates per 100000 immigrants were 6831 emergency department visits, 151 hospitalizations, and 4 deaths. In adjusted models, recent immigrants had the lowest risk of injury and risk increased over time (RR 0.79; 95% CI 0.77, 0.81 recent immigrants, RR 0.90; 95% CI 0.88, 0.92 intermediate immigrants, versus long-term immigrants). Factors associated with injury included young age (0-4 years, RR 1.30; 95% CI 1.26, 1.34), male sex (RR 1.52; 95% CI 1.49, 1.55), and high income (RR 0.93; 95% CI 0.89, 0.96 quintile 1 versus 5). Longer duration of residence was associated with a higher risk of unintentional injuries for most causes except hot object/scald burns, machinery-related injuries, non-motor vehicle bicycle and pedestrian injuries. The risk of these latter injuries did not change significantly with increasing duration of residence in Canada. Risk of drowning was highest in recent immigrants.ConclusionsRisk of all-cause and most cause-specific unintentional injuries in immigrants rises with increasing time since migration. This indicates the need to develop strategies for maintaining the immigrant health advantage over time while balancing the desire to support integration, active living, and healthy child development.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4612-1) contains supplementary material, which is available to authorized users.

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“…To compare how these firearm injuries relate to those from other causes, we refer readers to our recent paper in CMAJ Open, 3 which describes cause-specific injury rates in this same population.…”

Section: The Authors Respond To: "Questions On Analysis Of Firearm Inmentioning

confidence: 99%

The authors respond to: “Questions on analysis of firearm injuries study”

Saunders

Guttmann

2017

CMAJ

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Unintentional injuries in children and youth from immigrant families in Ontario, Canada: a population-based cross-sectional study

Cited by 8 publications

References 40 publications

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

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

The shrinking health advantage: unintentional injuries among children and youth from immigrant families

The authors respond to: “Questions on analysis of firearm injuries study”

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