South Asian ethnicity and risk of childhood accidents: an ecological study at enumeration district level in Leicester.
BACKGROUND
Surveys of 'self-reported' accidents suggest that South Asian children in the United Kingdom may have lower rates of childhood accidents, but little is known about their susceptibility to severe accidents compared with white children.


METHODS
We conducted an ecological study at the level of Census enumeration districts to compare hospital utilization as a result of childhood accidents according to White, South Asian, Black or 'Other' ethnic grouping and Townsend deprivation score in Leicester. Enumeration districts were assigned to postcoded data for fracture clinic attendances between 1997 and 1999 and in-patient admissions and in-patient stays of longer than 3 days as a result of accidents between 1995 and 1999 in children under 16 years.


RESULTS
South Asian children were less likely than white children to attend fracture clinic, be admitted or to have a prolonged stay as a result of an accident. Having adjusted for deprivation score, for a 10 per cent increase in the proportion of South Asian residents in an enumeration district, the odds ratio for an in-patient stay of longer than 3 days was 0.95 (95 per cent confidence interval (CI) 0.91-1.00, p = 0.035), for an accident admission the odds ratio was 0.93 (95 per cent CI 0.92-0.94, p < 0.001) and for attendance at fracture clinic the odds ratio was 0.94 (95 per cent CI 0.92-0.96, p < 0.001). For a district with 70 per cent of its children from South Asian groups (as observed in one-fifth of Leicester's enumeration districts), this represents a 40 per cent lower rate of accident admissions.


CONCLUSIONS
South Asian children were significantly less likely to utilize hospital services as a result of an accident. This may well be explained by differential exposure to accident hazards across ethnic groups, rather than by different thresholds of hospital attendance, given that hospital utilization was also lower for serious accidents in South Asian children.
Tobin
M D
MD
Department of Epidemiology and Public Health, University of Leicester, 22-28 Princess Road West, Leicester LE1 6TP. mt47@leicester.ac.uk
Milligan
J
J
Shukla
R
R
Crump
B
B
Burton
P R
PR
D000059:Accidents / Q000706:statistics & numerical data*; D000293:Adolescent; D001208:Asia / Q000208:ethnology; D019352:Censuses; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D016017:Odds Ratio; D010343:Patient Admission / Q000706:statistics & numerical data*; D012307:Risk Factors