Young adult's own and parental social characteristics predict injury morbidity: a register-based follow-up of 135,000 men and women.
BACKGROUND
Sociodemographic differences in injury mortality are well-established, but population-level studies on social patterns of injury morbidity remain few in numbers, particularly among young adults. Yet injuries are the leading cause of mortality, morbidity and disability among young people. Studies among children have shown steep social gradients in severe injuries, but less is known on the social patterning of injuries in late adolescence and early adulthood, when young people are in the process of becoming independent adults. This study examines how young adults' current living arrangements, education, main economic activity, and parental social background are associated with hospital-treated injuries in late adolescence and early adulthood.


METHODS
The study uses prospective, individual-level data gathered from several administrative sources. From a representative 11% sample of the total Finnish population, we included young people between ages 17-29 years during the follow-up (N = 134,938). We used incidence rates and Cox proportional hazards models to study hospital-treated injuries and poisonings in 1998-2008.


RESULTS
Higher rates of injury were found among young adults living alone, single mothers, the lower educated and the non-employed, as well as those with lower parental social background, experience of childhood family changes or living with a single parent, and those who had left the parental home at a young age. Injury risks were consistently higher among young adults with lower education, but current living arrangements and main economic activity showed some age-related nuances in the associations: both earlier and later than average transitions in education, employment, and family formation associated with increased injury risks. The social differentials were strongest in poisonings, intentional self-harm, and assaults, but social patterns were also found in falls, traffic-related injuries and other unintentional injuries, underlining the existence of multiple distinct mechanisms and pathways behind the differentials.


CONCLUSIONS
The transition to adulthood is a life period of heightened risk of injury, during which both parental social background and the young people's own social position are important determinants of serious injuries that require inpatient care.
Department of Social Research, University of Helsinki, P.O. Box 18, FI-00014, Helsinki, Finland. hanna.remes@helsinki.fi.
Hanna
H
Remes
Department of Social Research, University of Helsinki, P.O. Box 18, FI-00014, Helsinki, Finland. pekka.martikainen@helsinki.fi.|Max Planck Institute for Demographic Research, Rostock, Germany. pekka.martikainen@helsinki.fi.
Pekka
P
Martikainen
D000058:Accidental Falls; D000293:Adolescent; D000328:Adult; D004651:Employment; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D009017:Morbidity; D010290:Parents; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D066252:Sociological Factors; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult