title: The impact of deprivation on youth violence: a comparison of cities and their feeder towns.
abstract: OBJECTIVE
  66,000 children and adolescents are treated at emergency departments (EDs) in England and Wales each year for assault injury. The aim of this study was to compare adolescent assault injury rates in cities and towns and determine how assault injury varies with deprivation and gender.
  
  
  METHODS
  The study was set in three cities in Wales, UK, and their surrounding towns. Subjects were 11-17 year olds treated for assault injury at one of seven EDs from 1 October 2005 to 30 September 2006. Area of residence (electoral divisions, EDivs) was identified from patient postcode. EDivs were aggregated into deprivation fifths for males and females and cities and towns. Assault injury rates, rate ratios and 95% CIs were calculated.
  
  
  RESULTS
  1472 children and adolescents of 11-17 years old were treated for assault injury. Male city assault injury rates were 14.2/1000 11-17 year olds; and 13.1 in towns. Female city assault injury rates were 6.0; and 5.6 in towns. In the most deprived city areas males had assault injury rates 2.6 times (95% CI 1.85 to 3.59) that of the most affluent, compared with 2.0 times in towns (95% CI 1.39 to 2.86). For females, the most deprived city areas had assault injury rates 5.3 times that of the most affluent (95% CI 2.93 to 9.41), compared with 2.8 times in towns (95% CI 1.47 to 5.28).
  
  
  CONCLUSIONS
  Injury in youth violence increased with increasing deprivation in cities and their feeder towns. This was true for boys and girls, though rates for boys were consistently higher. This link between assault injury and deprivation was stronger for girls in cities than in feeder towns. Strategies to prevent youth violence need to include improved safeguarding arrangements for girls living in the most deprived city areas.
authors.affiliation: Department of Primary Care and Public Health, Welsh Combined Centres for Public Health, Cardiff University, Cardiff CF14 4XN, UK. jonessj3@cardiff.ac.uk
authors.forename: S J
authors.initials: SJ
authors.lastname: Jones
authors.forename: V
authors.initials: V
authors.lastname: Sivarajasingam
authors.forename: J
authors.initials: J
authors.lastname: Shepherd
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000367:Age Factors; D002423:Cause of Death; D002648:Child; D002947:Cities; D015331:Cohort Studies; D016001:Confidence Intervals; D016208:Databases, Factual; D004636:Emergency Service, Hospital; D004638:Emergency Treatment / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D011203:Poverty; D011610:Psychosocial Deprivation; D018570:Risk Assessment; D017678:Sex Distribution; D012931:Social Environment; D012959:Socioeconomic Factors; D016019:Survival Analysis; D006113:United Kingdom / Q000453:epidemiology; D014505:Urban Population; D014754:Violence / Q000706:statistics & numerical data*; D014852:Wales / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy