Childhood unintentional injury: The impact of family income, education level, occupation status, and other measures of socioeconomic status. A systematic review

Author:

Mahboob Afifa1,Richmond Sarah A23,Harkins Joshua P1,Macpherson Alison K1

Affiliation:

1. School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario

2. Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, Ontario

3. Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario

Abstract

Abstract Introduction Unintentional injuries represent a substantial public health burden among children and adolescents, and previous evidence suggests that there are disparities in injury by socioeconomic status (SES). This paper reports on a systematic review of literature on injury rates among children and adolescents by measures of SES. Methods A systematic literature search was conducted using six electronic databases: MEDLINE, PsycINFO, CINAHL, HealthSTAR, EMBASE, and SportsDiscus. This review considered children ages 19 years and under and publications between 1997 and 2017—representing an update since the last systematic review examined this specific question. Fifty-four articles were summarized based on study and participant descriptions, outcome and exposure, statistical tests used, effect estimates, and overall significance. Results Most articles addressed risk factors across all injury mechanisms; however, some focused particularly on burns/scalds, road traffic injuries, falls/drowning cases, and playground/sports injuries. Other studies reported on specific injury types including traumatic dental injuries, traumatic brain injuries, and fractures. The studies were of moderate quality, with a median of 15.5 (95% confidence interval [CI]: 15.34 to 15.66) out of 19. Thirty-two studies found an inverse association between SES and childhood unintentional injury, three found a positive association while twenty were not significant or failed to report effect measures. Conclusion Given the variability in definition of the exposure (SES) and outcome (injury), the results of this review were mixed; however, the majority of studies supported a relationship between low SES and increased injury risk. Public health practice must consider SES, and other measures of health equity, in childhood injury prevention programming, and policy.

Funder

Canadian Institutes of Health Research

Publisher

Oxford University Press (OUP)

Subject

Pediatrics, Perinatology, and Child Health

Reference60 articles.

1. The global burden of injury: Incidence, mortality, disability-adjusted life years and time trends from the global burden of disease study;Haagsma;Inj Prev,2013

2. Systematic review of the relationship between childhood injury and socio-economic status;Mackay,1999

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