Abstract
Limited longitudinal research has examined relationships between depression and injury, particularly in rural contexts. This paper reports cross-sectional and longitudinal analyses from the Australian Rural Mental Health Study (ARMHS) exploring relationships between “probable depression” episodes and unintentional injury. Participants completed four surveys over five years. Multivariate logistic regressions were employed to assess the causal effect of prior depression episodes on subsequent injury risk. Of 2621 baseline participants, 23.3% experienced a probable depression episode recently and 15.9% reported a serious injury during the previous 12 months. Factors associated with a 12-month injury at baseline included male gender, being unemployed or unable to work, being involved in a serious incident, hazardous alcohol use, and having experienced a recent depression episode. Longitudinal analyses revealed that probable depression was significantly associated with subsequent unintentional injury (OR 1.68, 99%CI 1.20–2.35), as was male gender (OR 1.39, 99%CI 1.06–1.82), while alcohol consumption did not mediate these relationships. Campaigns to reduce the impact of mental illness should consider unintentional injuries as a contributor, while injury prevention initiatives may benefit from addressing mental health issues. Such strategies are particularly important in rural and remote areas where injuries are more common and mental health services are less readily available.
Highlights
Injuries represent a substantial public health issue worldwide
There was a strong association between increasing depression likelihood and unintentional injury
No association was observed between past alcohol use and unintentional injury; Step 4 was not indicated. These results suggest that the effect of depression on subsequent injury risk was not mediated by alcohol consumption
Summary
Injuries represent a substantial public health issue worldwide. Acute injury is a major cause of hospitalisations in Australia and is in the top five burdensome disease groups, accounting for8.8% of total Disability-Adjusted Life Years [1]. Injuries represent a substantial public health issue worldwide. Acute injury is a major cause of hospitalisations in Australia and is in the top five burdensome disease groups, accounting for. 8.8% of total Disability-Adjusted Life Years [1]. In 2012–2013 there were 447,000 injuries requiring hospitalisation in Australia, accounting for 6% of all hospitalisations, with a further 1.8 million emergency room presentations [2]. The costs of injuries are significant and range from financial to social, human, and organisational. Unintentional injury may lead to temporary or permanent loss of income, as well as costs associated with initial treatment and ongoing. Res. Public Health 2017, 14, 1080; doi:10.3390/ijerph14091080 www.mdpi.com/journal/ijerph
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