title: Risk of Hospitalization Due to Unintentional Fall Injury in British Columbia, Canada, 1999-2008: Ecological Associations with Socioeconomic Status, Geographic Place, and Aboriginal Ethnicity.
abstract: Aboriginal people in British Columbia (BC), especially those residing on Indian reserves, have higher risk of unintentional fall injury than the general population. We test the hypothesis that the disparities are attributable to a combination of socioeconomic status, geographic place, and Aboriginal ethnicity.
  
  
  
  Within each of 16 Health Service Delivery Areas in BC, we identified three population groups: total population, Aboriginal off-reserve, and Aboriginal on-reserve. We calculated age and gender-standardized relative risks (SRR) of hospitalization due to unintentional fall injury (relative to the total population of BC), during time periods 1999-2003 and 2004-2008, and we obtained custom data from the 2001 and 2006 censuses (long form), describing income, education, employment, housing, proportions of urban and rural dwellers, and prevalence of Aboriginal ethnicity. We studied association of census characteristics with SRR of fall injury, by multivariable linear regression.
  
  
  
  The best-fitting model was an excellent fit (R2= 0.854, p < 0.001) and predicted SRRs very close to observed values for the total, Aboriginal off-reserve, and Aboriginal on-reserve populations of BC. After stepwise regression, the following terms remained: population per room, urban residence, labor force participation, income per capita, and multiplicative interactions of Aboriginal ethnicity with population per room and labor force participation.
  
  
  
  The disparities are predictable by the hypothesized risk markers. Aboriginal ethnicity is not an independent risk marker: it modifies the effects of socioeconomic factors. Closing the gap in fall injury risk between the general and Aboriginal populations is likely achievable by closing the gaps in socioeconomic conditions.
authors.affiliation: , 2762-133 Street, Surrey, BC, V4P 1X9, Canada. jin2007a@gmail.com.
authors.forename: Andrew
authors.identifier: 0000-0002-8708-2381
authors.initials: A
authors.lastname: Jin
authors.affiliation: Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.|Child and Family Research Institute, Room F508, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.|School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Mariana
authors.initials: M
authors.lastname: Brussoni
authors.affiliation: Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.|Child and Family Research Institute, Room F508, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.|School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
authors.forename: M Anne
authors.initials: MA
authors.lastname: George
authors.affiliation: Department of Psychology, University of Victoria, Victoria, BC, Canada.
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Lalonde
authors.affiliation: Faculty of Human, Social and Educational Development, Thompson Rivers University, Kamloops, BC, Canada.
authors.forename: Rod
authors.initials: R
authors.lastname: McCormick
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000328:Adult; D001955:British Columbia / Q000453:epidemiology; D004463:Ecology; D005260:Female; D054624:Health Status Disparities; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012307:Risk Factors; D012923:Social Class; D014947:Wounds and Injuries / Q000208:ethnology* / Q000628:therapy*
keywords: Accidental falls (MeSH); Epidemiology (MeSH); Indigenous population (MeSH); Wounds and injuries (MeSH); “First nations”; “Indians, North American” (MeSH)