Abstract
ObjectivesSocio-economic status (SES) is a well-established predictor of health outcomes; however, there is a dearth of evidence on the relationship between SES and off-road vehicle (ORV) injuries. In Ontario, all-terrain vehicles (ATVs) and snowmobiles present a serious risk for preventable injury. This study assessed the association between area-level material deprivation and the risk of ATV- and snowmobile-related injuries in Ontario, as well as the impact of sex and age.MethodsA population-based, repeat cross-sectional study was conducted using administrative data of ATV- and snowmobile-related emergency room visits from 2003 to 2018. Material deprivation was measured using the Ontario Marginalization Index, which assigned a score and quintile of deprivation to each dissemination area in Ontario. Age-standardized incidence rates and relative index of inequality values were calculated, stratified by quintile of deprivation, sex, age group, vehicle type, and health region.ResultsWe found a significant, positive relationship between ORV-related injuries and quintile of material deprivation (RII = 1.28, 95% CI: 1.01–1.63). Rates of ATV- and snowmobile-related injuries remained stable over time. Across all age groups, sex, and rural categories, we found an inverse u-shaped relationship between rates of injuries and quintile material deprivation. Males, individuals living in rural areas, and adolescents and young adults experienced the highest rates of injuries.ConclusionDespite the positive relationship between ORV-related injuries and quintiles of deprivation, the inverse u-shaped relationship suggests that this increased risk of injury is likely related to exposure to ORVs. These results contribute to an understanding of the prevalence of the injury problem at a local level in Ontario. Stable rates of injury over time suggest that current public health programs are not sufficient in reducing these injuries, and further research should determine which factors amenable to intervention are contributing to increased risk of injury.
Highlights
Socio-economic status (SES) has been recognized as an important predictor of both chronic and acute health outcomes (Lago et al 2018; Stringhini et al 2017)
Despite the relatively low rates found in highest quintile of material deprivation, the relative index of inequality (RII) of 1.28 indicates a significant association between material deprivation and off-road vehicle (ORV)-related injuries in Ontario (Table 1)
Similar trends by quintile of material deprivation exist across all age groups, where the ORV injury rate was the highest rate for the third quintile, while the lowest rates were found in the first quintile, followed by the fifth quintiles of material deprivation (Fig. 4)
Summary
Socio-economic status (SES) has been recognized as an important predictor of both chronic and acute health outcomes (Lago et al 2018; Stringhini et al 2017). Previous research has found that the direction of the relationship between SES and injuries depends on numerous factors, including the population under study, cause of injury, type of injury, measure of SES, and the physical environment (Cubbin & Smith 2002; Potter et al 2005; Simpson 2005). Several risk factors of ATV- and snowmobile-related injuries have been identified, such as driver and vehicle characteristics, use of protective gear, driving position, and driving patterns (Denning et al 2014; Rodgers 2001); to date, no studies have investigated the relationship between SES and ORVs
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