Abstract
BackgroundPrevious work has explored the significance of residence on injuries. A number of articles reported higher rates of injury in rural as compared to urban settings. This study aimed to evaluate the importance of residency on the occurrence of fractures among children and adolescents within a region in northern Sweden.MethodsIn a population based study with data from an injury surveillance registry at a regional hospital, we have investigated the importance of sex, age and place of residency for the incidence of fractures among children and adolescents 0-19 years of age using a Poisson logistic regression analysis. Data was collected between 1998 and 2011.ResultsThe dataset included 9,965 cases. Children and adolescents growing up in the most rural communities appeared to sustain fewer fractures than their peers in an urban municipality, risk ratio 0.81 (0.76-0.86). Further comparisons of fracture rates in the urban and rural municipalities revealed that differences were most pronounced for sports related fractures and activities in school in the second decade of life.ConclusionResults indicate that fracture incidence among children and adolescents is affected by place of residency. Differences were associated with activity at injury and therefore we have discussed the possibility that this effect was due to the influence of place on activity patterns.The results suggest it is of interest to explore how geographic and demographic variables affect the injury pattern further.Electronic supplementary materialThe online version of this article (doi:10.1186/2197-1714-1-14) contains supplementary material, which is available to authorized users.
Highlights
Previous work has explored the significance of residence on injuries
Previous work has shown a variation in the incidence of fractures with age (Cooper et al 2004; Landin 1983; Rennie et al 2007; Hedström et al 2010)
We have previously presented an epidemiological overview of fractures in children and adolescents
Summary
A number of articles reported higher rates of injury in rural as compared to urban settings. Previous work has shown a variation in the incidence of fractures with age (Cooper et al 2004; Landin 1983; Rennie et al 2007; Hedström et al 2010). Rural differences among children and adolescents have reported higher rates in rural settings (Carey et al 1993; Danseco et al 2000; Hammig and Weatherley 2003; Owen et al 2008; Singh et al 2012). There are studies that have shown no significant differences (Overpeck et al 1997; Ni et al 2002; Coben et al 2009), and higher rates of injuries among children in urban areas (Gilbride et al 2006)
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