Cross sectional survey of socioeconomic variations in severity and mechanism of childhood injuries in Trent 1992-7.
OBJECTIVE
To determine the relation between morbidity from injury and deprivation for different levels of injury severity and for different injury mechanisms for children aged 0-14 years.


METHODS
Cross sectional survey of routinely collected hospital admission data for injury 1992-7.


METHODS
862 electoral wards in Trent Region.


METHODS
21 587 injury related hospital admissions for children aged 0-4 years and 35 042 admissions for children aged 5-14.


METHODS
Rate ratios for hospital admission for all injuries, all injuries involving long bone fracture, and all injuries involving long bone fracture requiring an operation; rate ratios for hospital admission for six types of injury mechanism divided by quintiles of the electoral wards' Townsend scores for deprivation. Rate ratios calculated by Poisson regression, with adjustment for distance from nearest hospital admitting patients with injuries, rurality, ethnicity, and percentage of males in each electoral ward.


RESULTS
Both total number of admissions for injury and admissions for injuries of higher severity increased with increasing socioeconomic deprivation. These gradients were more marked for 0-4 year old children than 5-14 year olds. In terms of injury mechanisms, the steepest socioeconomic gradients (where the rate for the fifth of electoral wards with the highest deprivation scores was > or =3 times that of the fifth with the lowest scores) were for pedestrian injuries (adjusted rate ratio 3.65 (95% confidence interval 2.94 to 4.54)), burns and scalds (adjusted rate ratio 3.49 (2.81 to 4.34)), and poisoning (adjusted rate ratio 2.98 (2.65 to 3.34)).


CONCLUSIONS
There are steep socioeconomic gradients for injury morbidity including the most common mechanisms of injury. This has implications for targeting injury prevention interventions and resources.
Hippisley-Cox
Julia
J
Division of General Practice, Tower Building University Park, Nottingham NG7 2RD. julia.hippisley-cox@nottingham.ac.uk
Groom
Lindsay
L
Kendrick
Denise
D
Coupland
Carol
C
Webber
Elizabeth
E
Savelyich
Boki
B
D000059:Accidents / Q000706:statistics & numerical data*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015601:Injury Severity Score; D009017:Morbidity; D011203:Poverty; D012307:Risk Factors; D012959:Socioeconomic Factors; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology*