Abstract
Injuries are a leading cause of harm for children. This study explores the impact of determinants of health on children (0–19 years) injury-related mortality (namely remoteness and socio-economic disadvantage, calculated using the index of relative socio-economic advantage and disadvantage (IRSAD)). Cause of death data from the Australian Bureau of Statistics were sourced for children in Australia between 1 July 2007 to 30 June 2017. Fifteen injury categories (ICD-10-AM external cause codes) were used. Burden and trends by injury mechanism were explored. A total of 5153 children died; with road traffic incidents (3.39 per 100,000 population), intentional self-harm (2.46) and drowning (0.72) being the leading mechanisms. Female fatality rates in very remote areas (8.73) were nine times higher than in major cities (Relative Risk [RR] = 8.73; 95% Confidence Interval [95% CI]: 4.23–18.00). Fatality rates increased with remoteness; very remote areas recording an injury-related fatality rated six times (RR = 5.84; 95% CI: 3.76–9.12) that of major city residents. Accidental poisoning and intentional self-harm fatalities were more likely in high IRSAD areas, while road traffic fatalities were more likely in low and mid socio-economic areas (X2 = 69.1; p < 0.001). People residing in regional and remote areas and from low socio-economic backgrounds already face significant health and lifestyle challenges associated with disadvantage. It is time to invest in injury prevention interventions for these populations, as well as upstream policy strategies to minimize any further preventable loss of life.
Highlights
Injuries are a leading cause of mortality and morbidity for children and adolescents
This study has explored the impact of determinants of health, namely remoteness of residential location and IRSAD of residential location on injury-related fatalities among 0–19-year-olds in Australia
This study has explored the impact of determinants of health, namely the geographical remoteness of residence and socio-economic status of residential area on injury-related fatalities among children aged 0–19 years in Australia
Summary
Injuries are a leading cause of mortality and morbidity for children and adolescents. In 2017, the Global Burden of Disease study estimated 4.48 million injury deaths globally, an increase of 5.3% since 1990 [1]. Some progress is being made in reducing injury-related deaths, with both years of life lost and age-standardized mortality rates decreasing between 1990 and 2017 [1]. Injury-related morbidity is a significant global concern. New cases of non-fatal injury are increasing, with 520 million cases recorded globally in 2017, while years lived with a disability increased [1]. As the risk factors and prevention strategies needed to address unintentional and intentional injuries often differ, there is a need for studies which explore the causes of injury by age groups
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