Abstract
Unintentional injury is the leading cause of childhood death and disability in many countries worldwide. This study aimed to quantify rates and risk factors for childhood unintentional injury in areas of rural China, where many children are left behind by migrant worker parents. We administered a questionnaire to children aged 9 to 15, in 56 schools in five counties in Zhejiang and Guizhou provinces. Of the 3791 respondents, 44% lived with both parents, 23% with one parent, and 33% with neither. Around half the children (47.9%) had suffered at least one unintentional injury in the past year, with burns (26%), animal bites (20%) and mechanical injury (18%) the most common. Left-behind children had no increased risk of unintentional injury, but children living in poorer Guizhou (p = 0.001), of divorced parents (p = 0.02), and less well-educated mothers (p = 0.02) were associated with higher risk. Virtual absence of personal level risk factors highlights the importance of addressing environmental risk to reduce childhood injury. The findings have informed a community-based intervention to reduce injury risk through raising awareness of environmental hazards, and through removal of specific hazards. Importantly, the Chinese government should ensure that known effective interventions are subject to legislation and enforcement.
Highlights
Children are especially vulnerable to unintentional injury, and it is the leading cause of death and disability in children in many low- and middle-income countries (LMIC) [1]
The aims of this study were to: (1) Measure the incidence of unintentional injury in left-behind children compared with non-left-behind children, (2) identify the risk factors associated with children’s unintentional injury, and (3) inform the proposed intervention and local policy measures
There were 1254 (33.2%) children living with neither parent, 861 (22.7%) living with one parent, and 1676 (44.2%) living with both parents, with more left-behind children in Guizhou (57.9%)
Summary
Children are especially vulnerable to unintentional injury, and it is the leading cause of death and disability in children in many low- and middle-income countries (LMIC) [1]. China has a high burden of disease from unintentional injury in children. In 2010 it was the leading cause of death and disability in children under 18, with 86,000 children dying as a result of unintentional injury, accounting for 26% of all child deaths [2]. The non-fatal incidence of unintentional injury in China is impossible to estimate on the current evidence because of widely varying definitions of injury, and the range of locations and age groups investigated in research studies [3,4,5,6,7]. What is clear is that unintentional injury has devastating effects for children and families but is associated with considerable healthcare and social costs [8]
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