title: Socioeconomic Status and Non-Fatal Adult Injuries in Selected Atlanta (Georgia USA) Hospitals.
abstract: BACKGROUND
  Injury mortality data for adults in the United States and other countries consistently show higher mortality for those with lower socioeconomic status (SES). Data are sparse regarding the role of SES among adult, non-fatal US injuries. The current study estimated non-fatal injury risk by household income using hospital emergency department (ED) visits.
  
  
  METHODS
  A total of 1,308,892 ED visits at 10 Atlanta (Georgia USA) hospitals from 2001-2004 (347,866 injuries) were studied. The SES was based on US census-block group income, with subjects assigned to census blocks based on reported residence. Logistic regression was used to determine risk by SES for injuries versus all other ED visits, adjusting for demographics, hospital, and weather. Supplemental analyses using hospital data from 2010-2013, without data on SES, were conducted to determine whether earlier patterns by race, age, and gender persisted.
  
  
  RESULTS
  Risk for many injury categories increased with higher income. Odds ratio by quartiles of increasing income (lowest quartile as referent, 95% confidence interval [CI] given for upper most quartile) were 1.00, 1.23, 1.34, 1.40 (95% CI 1.36-1.45) for motor vehicle accidents; 1.00, 1.03, 1.11, 1.24 (95% CI 1.20-1.29) for being struck by objects; 1.00. 0.99, 1.04, 1.12 (95% CI 1.00-1.25) for suicide; and 1.00, 1.03, 1.05, 1.12 (95% CI 1.09-1.15) for falls. In contrast, decreased injury risk with increased household income was seen for assaults (1.00, 0.83, 0.73, 0.67 [95% CI 0.63-0.72], by increasing quartiles). These trends by income did not differ markedly by race and gender. Whites generally had less risk of injuries, with the exception of assaults and motor vehicle accidents. Males had higher risk of injury than females, with the exception of falls and suicide attempts. Patterns of risk for race, age, and gender were consistent between 2001-2004 and 2010-2013.
  
  
  CONCLUSIONS
  For most non-fatal injuries, those with higher income had more risk of ED visits, although the opposite was true for assault. Hulland E , Chowdhury R , Sarnat S , Chang HH , Steenland K . Socioeconomic status and non-fatal adult injuries in selected Atlanta (Georgia USA) hospitals. Prehosp Disaster Med. 2017;32(4):403-413.
authors.affiliation: 1Department of Biostatistics and Bioinformatics,Rollins School of Public Health,Emory University,Atlanta,GeorgiaUSA.
authors.forename: Erin
authors.initials: E
authors.lastname: Hulland
authors.affiliation: 2Department of Epidemiology,James T. Laney School of Graduate Studies,Emory University,Atlanta,GeorgiaUSA.
authors.forename: Ritam
authors.identifier: http://orcid.org/0000-0002-7319-9503
authors.initials: R
authors.lastname: Chowdhury
authors.affiliation: 4Department of Environmental Health,Rollins School of Public Health and James T. Laney School of Graduate Studies,Emory University,Atlanta,GeorgiaUSA.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Sarnat
authors.affiliation: 1Department of Biostatistics and Bioinformatics,Rollins School of Public Health,Emory University,Atlanta,GeorgiaUSA.
authors.forename: Howard H
authors.initials: HH
authors.lastname: Chang
authors.affiliation: 2Department of Epidemiology,James T. Laney School of Graduate Studies,Emory University,Atlanta,GeorgiaUSA.
authors.forename: Kyle
authors.initials: K
authors.lastname: Steenland
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003710:Demography; D004636:Emergency Service, Hospital; D005006:Ethnicity; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D012923:Social Class; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000208:ethnology / Q000401:mortality; D055815:Young Adult
keywords:  ED emergency department;  NHIS National Health Interview Survey;  SES socioeconomic status;  SOPHIA Study of Particles and Health in Atlanta;  hospital;  traffic; United States; accidents; emergency service; income; social class