Socioeconomic status and risk of car crash injury, independent of place of residence and driving exposure: results from the DRIVE Study.
BACKGROUND
Previous studies that found increased crash risks for young drivers of low socioeconomic status (SES) have failed to adjust for factors such as driving exposure and rural residence. This aim of this study is to examine the independent effect of SES on crash risk, adjusting for such factors, and to examine the relationship between injury severity following a crash and SES.


METHODS
Information on risk factors for crash collected from 20,822 newly licenced drivers aged 17-24 years in New South Wales, Australia, as part of the DRIVE Study was prospectively linked to hospitalisation data. SES was classified as high, moderate or low based on the Australia 2001 Socio-Economic Index for Areas. Poisson regression was used to model risk of crash-related hospitalisation by SES, adjusting for confounders. Two measures of injury severity--urgency of treatment and length of hospital stay--were examined by SES.


RESULTS
Results of multivariable analysis showed that drivers from low SES areas had increased relative risk (RR 1.8, 95% CI 1.1 to 3.1) of crash-related hospitalisation compared to drivers from high SES areas. This increased risk remained when adjusting for confounders including driving exposure and rurality (RR 1.9, 95% CI 1.1 to 3.2). No significant association was found between injury severity and SES.


CONCLUSIONS
The higher risk of crash-related hospitalisation for young drivers from low SES areas is independent of driving exposure and rural-urban differences. This finding may help improve and better target interventions for youth of low SES.
Chen
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The George Institute for Global Health, The University of Sydney, PO Box M201, Missenden Road, Sydney, NSW 2050, Australia.
Ivers
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Martiniuk
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Boufous
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Senserrick
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Woodward
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Stevenson
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Norton
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D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D001334:Automobile Driving / Q000706:statistics & numerical data*; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009517:New South Wales / Q000453:epidemiology; D016012:Poisson Distribution; D011446:Prospective Studies; D012111:Residence Characteristics / Q000145:classification; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D012923:Social Class; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult