title: Are we failing our rural communities? Motor vehicle injury in British Columbia, Canada, 2001-2007.
abstract: In Canada, stratification by geographic area or socio-economic status remains relatively rare in national and provincial reporting and surveillance for injury prevention and trauma care. As injuries are known to affect some populations more than others, a more nuanced understanding of injury risk may in turn inform more effective prevention policy. In this study we assessed rates of hospitalization and death from motor vehicle collisions (MVC) in British Columbia (BC) by socio-economic status (SES) and by rural and urban status between 2001 and 2007. Excess risk in injury morbidity and mortality between different SES groups were assessed using a population attributable fraction (PAF). Over a six-year period rural populations in BC experienced a three-fold increase in relative risk of death and an average of 50% increase in relative risk of hospitalization due to injury. When assessed against SES, relative risk of MVC mortality increased from 2.36 (2.05-2.72) to 4.07 (3.35-4.95) in reference to the least deprived areas, with an estimated 40% of all MVC-related mortality attributable to the relative differences across SES classes. Results from this study challenge current provincial and national reporting practises and emphasize the utility of employing the PAF for assessing variations in injury morbidity and mortality.
authors.affiliation: Department of Surgery, University of British Columbia, Canada. nathaniel.bell@vch.ca
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Bell
authors.forename: Richard K
authors.initials: RK
authors.lastname: Simons
authors.forename: Nasira
authors.initials: N
authors.lastname: Lakha
authors.forename: S Morad
authors.initials: SM
authors.lastname: Hameed
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality / Q000517:prevention & control / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001955:British Columbia / Q000453:epidemiology; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011050:Policy Making; D011159:Population Surveillance; D012307:Risk Factors; D012424:Rural Population; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D055815:Young Adult