title: Parental educational level and injury incidence and mortality among foreign-born children: a cohort study with 46 years follow-up.
abstract: BACKGROUND
  Injury risk during childhood and adolescence vary depending on socio-economic factors. The aim of this study was to study if the risk of fatal and non-fatal unintentional injuries among foreign-born children was similar across parental educational level or not.
  
  
  METHODS
  In this retrospective cohort study we followed 907,335 children between 1961 and 2007 in Sweden. We established the cohort by linkage between Swedish national registers including cause of death register and in-patient register, through unique Personal Identification Numbers. The main exposure variable was parental (maternal and paternal) educational level. The cohorts was followed from start date of follow-up period, or date of birth whichever occurred last, until exit date from the cohort, which was date of hospitalization or death due to unintentional injury, first emigration, death due to other causes than injury or end of follow-up, whichever came first. We calculated hazard ratios (HR) with 95% confidence intervals (95% CI) by Cox proportional hazards regression models.
  
  
  RESULTS
  Overall, we found 705 and 78,182 cases of death and hospitalization due to unintentional injuries, respectively. Risk of death and hospitalization due to unintentional injuries was statistically significantly 1.48 (95% CI: 1.24-1.78) and 1.10 (95% CI: 1.08-1.12) times higher among children with lowest parental educational level (9 years and shorter years of study) compared to children with highest parental educational level (+13 years of study). We found similar results when stratified our study group by sex of children, by maternal and paternal educational level separately, and injury type (traffic-related, fall, poisoning, burn and drowning).
  
  
  CONCLUSIONS
  It seems injury prevention work against unintentional injuries is less effective among children with low parental education compared with those with higher parental education. We recommend designing specific preventive interventions aiming at children with low parental education.
authors.forename: Omid
authors.initials: O
authors.lastname: Beiki
authors.affiliation: Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran. Email: kariminajmeh@yahoo.com.
authors.forename: Najmeh
authors.initials: N
authors.lastname: Karimi
authors.forename: Reza
authors.initials: R
authors.lastname: Mohammadi
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D015331:Cohort Studies; D016001:Confidence Intervals; D004522:Educational Status; D054242:Emigrants and Immigrants / Q000193:education / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D010290:Parents / Q000193:education*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013548:Sweden / Q000453:epidemiology; D014947:Wounds and Injuries / Q000145:classification / Q000209:etiology / Q000401:mortality
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