Understanding pathways to social inequalities in childhood unintentional injuries: findings from the UK millennium cohort study

Campbell, M., Lai, E.T.C., Pearce, A. , Orton, E., Kendrick, D., Wickham, S. and Taylor-Robinson, D.C. (2019) Understanding pathways to social inequalities in childhood unintentional injuries: findings from the UK millennium cohort study. BMC Pediatrics, 19, 150. (doi:10.1186/s12887-019-1514-7) (PMID:31088415) (PMCID:PMC6518796)

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Abstract

Background: Childhood unintentional injuries (UI) are common but continue to happen more often to children living in less advantaged socioeconomic circumstances (SEC). Our aim was to explore how early life factors mediate the association between SEC and UIs, using the UK Millennium Cohort Study. Methods: We calculated risk ratios (RR) and 95% confidence intervals (95%CI) for parental report of UI occurring between age 3 and 5 years, using Poisson regression according to family income as a measure of SEC. We explored potentially mediating pathways by controlling associations between SEC and UI for groups of early life risks in three domains: factors that may influence environmental safety, supervision and the MCS child’s abilities and behaviours. Results: Twenty eight percent of children had a UI from 3 to 5 years old. Children from the lowest income quintile were more likely to be injured compared to those from the highest (RR 1.20 95%CI 1.05, 1.37). Sequentially controlling for early life factors that may influence environmental safety (RR 1.19 95%CI 1.02, 1.38), then supervision (RR 1.18, 95%CI 1.02, 1.36), and finally adding child’s behaviour and abilities (RR 1.15, 95%CI 1.00, 1.34) into the model reduced the RR by 5, 10 and 25% respectively. Conclusions: Addressing factors that may influence environmental safety and supervision, and the child’s abilities and behaviours only partly explains the increased UI risk between the highest and lowest income quintiles. Further research is required to explore factors mediating associations between SEC and specific mechanisms and types of injuries.

Item Type:Articles
Additional Information:No specific funding was received for this study. MC was funded by a Health Education England Fellowship Grant. DTR and ETCL are funded by an MRC Clinician Scientist Fellowship (ref MR/P008577/1). SLW is supported by a Wellcome Trust Society and Ethics fellowship (grant number 200335/Z/15/Z). Our work was also supported by The Farr Institute for Health Informatics Research (Medical Research Council grant MR/M0501633/1).
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Pearce, Dr Anna
Authors: Campbell, M., Lai, E.T.C., Pearce, A., Orton, E., Kendrick, D., Wickham, S., and Taylor-Robinson, D.C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO Unit
Journal Name:BMC Pediatrics
Publisher:BMC
ISSN:1471-2431
ISSN (Online):1471-2431
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in BMC Pediatrics 19:150
Publisher Policy:Reproduced under a Creative Commons License

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