Abstract
Injury is the leading cause of death among children and youth in Canada. Significant disparities in injury mortality rates have been observed between Aboriginal and non-Aboriginal populations, but little is known about the age-, sex-, and mechanism-specific patterns of injury causing death. This study examines paediatric mortality in British Columbia from 2001 to 2009 using comprehensive vital statistics registry data. We highlight important disparities in Aboriginal and non-Aboriginal mortality rates, and use the Preventable Years of Life Lost (PrYLL) metric to identify differences between age groups and the mechanisms of injury causing death. A significantly greater age-adjusted mortality rate was observed among Aboriginal children (OR = 2.08, 95% CI: 1.41, 3.06), and significantly higher rates of death due to assault, suffocation, and fire were detected for specific age groups. Mapped results highlight regional disparities in PrYLL across the province, which may reflect higher Aboriginal populations in rural and remote areas. Crucially, these disparities underscore the need for community-specific injury prevention policies, particularly in regions with high PrYLL.
Highlights
Injury is the leading cause of death for children above the age of five worldwide, and above the age of one in Canada [1,2,3]
Most evident in the Canadian context is the socioeconomic gradient of injury mortality and morbidity rates between Aboriginal and non-Aboriginal populations
A greater number of paediatric injury deaths occurred among males in all three age groups (Table 1), and while the difference was larger among older age groups, this was not a statistically significant difference (Cochran-Armitage χ2 = 2.611, df = 1, p = 0.106)
Summary
Injury is the leading cause of death for children above the age of five worldwide, and above the age of one in Canada [1,2,3]. A report published a decade earlier by Health Canada on the mechanisms of injury-related death found higher mortality rates among Aboriginal populations due to suicide, fire, drowning, and motor vehicle collisions [10]. While the few previous studies that do exist provide relatively consistent mortality and morbidity estimates, this study is unique in that it uses a Preventable Years of Life Lost (PrYLL) metric for quantifying and comparing the impact of injury on Aboriginal and non-Aboriginal populations. PrYLL is the number of life-years lost due to preventable causes, as opposed to all-cause mortality and has been used in several previous injury studies [17,18] This metric is useful for quantifying the societal burden of child and youth injury and highlighting opportunities for prevention policy and practice. They have been proven to be a powerful tool for the analysis and dissemination of such information [21]
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