title: Socio Economic Status and Traumatic Brain Injury amongst Pediatric Populations: A Spatial Analysis in Greater Vancouver.
abstract: BACKGROUND
  Within Canada, injuries are the leading cause of death amongst children fourteen years of age and younger, and also one of the leading causes of morbidity. Low Socio Economic Status (SES) seems to be a strong indicator of a higher prevalence of injuries. This study aims to identify hotspots for pediatric Traumatic Brain Injury (TBI) and examines the relationship between SES and pediatric TBI rates in greater Vancouver, British Columbia (BC), Canada.
  
  
  METHODS
  Pediatric TBI data from the BC Trauma Registry (BCTR) was used to identify all pediatric TBI patients admitted to BC hospitals between the years 2000 and 2013. Spatial analysis was used to identify hotspots for pediatric TBI. Multivariate analysis was used to distinguish census variables that were correlated with rates of injury.
  
  
  RESULTS
  Six hundred and fifty three severe pediatric TBI injuries occurred within the BC Lower Mainland between 2000 and 2013. High rates of injury were concentrated in the East, while low rate clusters were most common in the West of the region (more affluent neighborhoods). A low level of education was the main predictor of a high rate of injury (OR = 1.13, 95% CI = 1.03-1.23, p-Value 0.009).
  
  
  CONCLUSIONS
  While there was a clear relationship between different SES indicators and pediatric TBI rates in greater Vancouver, income-based SES indicators did not serve as good predictors within this region.
authors.affiliation: Department of Geography, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada. oamram@sfu.ca.
authors.forename: Ofer
authors.initials: O
authors.lastname: Amram
authors.affiliation: Department of Geography, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada. nadine@sfu.ca.
authors.forename: Nadine
authors.initials: N
authors.lastname: Schuurman
authors.affiliation: Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada; BC Injury Research and Prevention Unit, Child and Family Research Institute, BC Children's Hospital, Vancouver V6H 3V4, Canada. ipike@cw.bc.ca.
authors.forename: Ian
authors.initials: I
authors.lastname: Pike
authors.affiliation: Department of Surgery, Dalhousie University, Halifax, NS B3H 4R2, Canada. Natalie.Yanchar@iwk.nshealth.ca.
authors.forename: Natalie L
authors.initials: NL
authors.lastname: Yanchar
authors.affiliation: Faculty of Health Science, Ben Gurion University, Beer Sheva 8410501, Israel. friger@bgu.ac.il.
authors.forename: Michael
authors.initials: M
authors.lastname: Friger
authors.affiliation: Departments of Surgery and Critical Care Medicine, Alberta Health Services, Calgary, AB T6G 2R3, Canada. pmcbeth@gmail.com.
authors.forename: Paul B
authors.initials: PB
authors.lastname: McBeth
authors.affiliation: Department of Anesthesiology, Pharmacology &amp; Therapeutics, University of British Columbia, Vancouver, BC V6T 1Z4, Canada. Donald.Griesdale@vch.ca.
authors.forename: Donald
authors.initials: D
authors.lastname: Griesdale
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000453:epidemiology / Q000209:etiology*; D001955:British Columbia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004522:Educational Status; D005260:Female; D006801:Humans; D007182:Income; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011204:Poverty Areas; D015995:Prevalence; D012042:Registries; D012111:Residence Characteristics; D012307:Risk Factors; D012923:Social Class; D062206:Spatial Analysis
keywords: geographic information systems; injury hotspot; injury prevention; pediatric injury; traumatic brain injury