Child injury risks are close to home: parent psychosocial factors associated with child safety.
OBJECTIVE
In several populations, maternal depression has been associated with reduced child safety. In an urban pediatric Emergency Department, we examined the relationship between parental depression, social support, and domestic conflict and child safety behaviors.


METHODS
We studied consecutive patients in an Emergency Department. Trained interviewers used a structured instrument to assess patient, primary caregiver, and household demographics, socio-economic status, psychosocial factors, child safety behaviors (whether a gun was in the home, poisons were locked, a functioning smoke detector was present, and use of carseats or seatbelts), and whether the home was smoke-free. 1,116 patients provided adequate data.


RESULTS
Depression was associated with a modest and not statistically significant reduction in child safety behaviors in this population. Lack of social support and the presence of domestic conflict were robustly, independently, and statistically significantly associated with less safe homes. Domestic conflict was associated with more smoking in the home.


CONCLUSIONS
In our population, child safety was associated less with depression and more with parental lack of social support and domestic conflict. These can be assessed in a Emergency Department and may be amenable to intervention.
Rhodes
Karin V
KV
Division of Health Policy Research, Department of Emergency Medicine, School of Social Policy and Practice, University of Pennsylvania School of Medicine, 3815 Walnut St., Philadelphia, PA 19104, USA. kvr@sp2.upenn.edu
Iwashyna
Theodore J
TJ
D000061:Accidents, Home / Q000517:prevention & control / Q000706:statistics & numerical data*; D000328:Adult; D002648:Child; D002654:Child Care / Q000379:methods* / Q000523:psychology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology; D017579:Domestic Violence / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010290:Parents / Q000193:education / Q000523:psychology*; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012309:Risk-Taking; D012449:Safety; D012944:Social Support; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000517:prevention & control