Social disparities in housing and related pediatric injury: a multilevel study.
OBJECTIVE
We conducted an ecologic analysis to determine whether housing characteristics mediate the associations between concentration of poverty and pediatric injury and between concentration of racial minorities and pediatric injury and whether the association between housing conditions and pediatric injury is independent of other risks.


METHODS
We created a hierarchical data set by linking individual-level data for pediatric injury with census data. Effect sizes were estimated with a Poisson model.


RESULTS
After adjustment for owner occupancy and the percentage of housing built before 1950, the association between concentration of poverty and pediatric injury was attenuated. For concentration of racial minorities, only percentage of owner occupancy had some mediating effect. In hierarchical models, housing characteristics remained independent and significant predictors of pediatric injury.


CONCLUSIONS
The association between community characteristics and pediatric injury is partially mediated by housing conditions. Risk of pediatric injury associated with housing conditions is independent of other risks.
Shenassa
Edmond D
ED
Department of Community Health and the Centers for Behavioral and Preventive Medicine, Brown Medical School/Miriam Hospital, Providence, RI 02903, USA. edmond_shenassa@brown.edu
Stubbendick
Amy
A
Brown
Mary Jean
MJ
D000058:Accidental Falls / Q000706:statistics & numerical data; D017677:Age Distribution; D002056:Burns / Q000453:epidemiology / Q000209:etiology; D002648:Child; D002669:Child Welfare / Q000706:statistics & numerical data*; D002675:Child, Preschool; D005260:Female; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data; D006798:Housing / Q000706:statistics & numerical data*; D006801:Humans; D007087:Illinois; D007223:Infant; D008297:Male; D008913:Minority Groups / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D010067:Ownership / Q000706:statistics & numerical data; D016012:Poisson Distribution; D011159:Population Surveillance; D011204:Poverty Areas; D012307:Risk Factors; D012931:Social Environment; D012959:Socioeconomic Factors; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology