Serious injuries in children: variation by area deprivation and settlement type.
OBJECTIVE
To examine the variation in serious injuries in children by the level of deprivation in an area and by types of settlement.


METHODS
Hospital admission rates for serious injury to children aged 0-15 years in census lower super output areas in England during the 5-year period 1 April 1999 to 31 March 2004 were analysed.


RESULTS
Rates of serious injury in children were higher in the most deprived areas than in the least deprived for pedestrians (rate ratio (RR) 4.1; 95% CI 2.8 to 6.0) and cyclists (RR 3.0; 95% CI 1.9 to 4.7). Rates of serious pedestrian injury were lower in towns and fringe areas (RR 0.67; 95% CI 0.53 to 0.86) and in village (RR 0.64; 95% CI 0.50 to 0.83) areas than in urban areas. The rate of serious injury to cyclists was lower in London than other urban areas (RR 0.78; 95% CI 0.62 to 0.98). The rate of serious injury to car occupants was higher in village than urban areas (RR 1.51; 95% CI 1.05 to 2.17). Rates of serious injury caused by falls were higher in London (RR 1.60; 95% CI 1.47 to 1.75) and lower in villages (RR 0.76; 95% CI 0.66 to 0.88) than in urban areas. Steeper socio-economic gradients in serious injury rates were identified in rural areas for cyclists and for children suffering falls.


CONCLUSIONS
Socio-economic inequalities in serious injury exist across the whole of England, particularly for child pedestrians. Rates of serious injury vary by settlement type, and inequalities vary by cause of injury between rural and urban settings.
Edwards
P
P
Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK. phil.edwards@LSHTM.ac.uk
Green
J
J
Lachowycz
K
K
Grundy
C
C
Roberts
I
I
D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000063:Accidents, Traffic / Q000517:prevention & control / Q000706:statistics & numerical data*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004332:Drowning / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011041:Poisoning / Q000453:epidemiology* / Q000517:prevention & control; D011204:Poverty Areas; D012423:Rural Health / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D006113:United Kingdom; D014504:Urban Health / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control