@article{ref1, title="Social inequalities and hospital admission for unintentional injury in young children in Scotland: a nationwide linked cohort study", journal="Lancet regional health. Europe", year="2021", author="Henery, Paul M. and Dundas, Ruth and Katikireddi, S. Vittal and Leyland, Alastair and Wood, Rachael and Pearce, Anna", volume="6", number="", pages="e100117-e100117", 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. FUNDING: Wellcome Trust, Medical Research Council, Scottish Government Chief Scientist Office.

Language: en

", language="en", issn="2666-7762", doi="10.1016/j.lanepe.2021.100117", url="http://dx.doi.org/10.1016/j.lanepe.2021.100117" }