Henery, P. M., Dundas, R. , Katikireddi, S. V. , Leyland, A. , Wood, R. and Pearce, A. (2021) Social inequalities and hospital admission for unintentional injury in young children in Scotland: a nationwide linked cohort study. Lancet Regional Health - Europe, 6, 100117. (doi: 10.1016/j.lanepe.2021.100117) (PMID:34291228) (PMCID:PMC8278494)
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Abstract
Background: Unintentional injury is a leading cause of death/disability, with more disadvantaged children at greater risk. Understanding how inequalities vary by injury type, age, severity, and place of injury, can inform prevention. Methods: For all Scotland-born children 2009-2013 (n=195,184), hospital admissions for unintentional injury (HAUI) were linked to socioeconomic circumstances (SECs) at birth: area deprivation via the Scottish Index of Multiple Deprivation (SIMD), mother's occupational social class, parents’ relationship status. HAUI was examined from birth-five, and during infancy. We examined HAUI frequency, severity, injury type, and injury location (home vs. elsewhere). We estimated relative inequalities using the relative indices of inequality (RII, 95% CIs), before and after adjusting for demographics and other non-mediating SECs. Findings: More disadvantaged children were at greater risk of any HAUI from birth-five, RII: 1•59(1•49-1•70), 1•74(1•62-1•86), 1•97(1•84-2•12) for area deprivation, maternal occupational social class, and relationship status respectively. These attenuated after adjustment (1•15 [1•06-1•24], 1.22 [1•12-1•33], 1.32 [1•21-1•44]). Inequalities were greater for severe (vs. non-severe), multiple (vs. one-off) and home (vs. other location) injuries. Similar patterns were seen in infancy, excluding SIMD-inequalities in falls, where infants living in more disadvantaged neighbourhoods were at lower risk (0•79 [0•62-1•00]). After adjustment, reverse SIMD-gradients were also observed for all injuries and poisonings. Interpretation: Children living in more disadvantaged households are more likely to be injured across multiple dimensions of HAUI in Scotland. Upstream interventions which tackle family-level disadvantage may be most effective at reducing childhood HAUI.
| Item Type: | Articles |
|---|---|
| Additional Information: | PMH and AP are supported by funds from the Wellcome Trust [205412/Z/16/Z]. PMH, RD, SVK, AL, and AP are supported by funds from the Medical Research Council [ MC_UU_00022/2 ] and the Scottish Government Chief Scientist Office [SPHSU17]. SVK is funded by a NRS Senior Clinical Fellowship ( SCAF/15/02 ). |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Katikireddi, Professor Vittal and Leyland, Professor Alastair and Pearce, Dr Anna and Henery, Mr Paul and Dundas, Professor Ruth |
| Authors: | Henery, P. M., Dundas, R., Katikireddi, S. V., Leyland, A., Wood, R., and Pearce, A. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU |
| Journal Name: | Lancet Regional Health - Europe |
| Publisher: | Lancet Publishing Group |
| ISSN: | 2666-7762 |
| ISSN (Online): | 2666-7762 |
| Published Online: | 09 May 2021 |
| Copyright Holders: | Copyright © 2021 The Authors |
| First Published: | First published Lancet Regional Health - Europe 6:100117 |
| Publisher Policy: | Reproduced under a Creative Commons License |
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