Abstract
BackgroundThis study examines social disparities across neighbourhood levels of income, education and employment in relation to overall injury hospital separations in the province of British Columbia, Canada. Further, the study examines the relationships of social disparities to a set of three injury prevention priorities in British Columbia, namely, transport (motor vehicle occupant, pedestrian and cyclist), falls among older adults, and youth self-harm. The goal being to better understand area-based injury incidence with a view to precision prevention initiatives, particularly for more vulnerable populations.MethodsAcute hospital separations from the Discharge Database were identified for all causes of injury and the three BC injury prevention priorities for the period April 1, 2009 to March 31, 2014, inclusive. An ecological approach was applied where each hospital separation case was attributed with the income, education and employment level according to the injured individual’s area of residence, derived from the 2011 CensusPlus data.ResultsInjury hospital separation data were available for 191 Forward Sortation Areas in BC. Between April 1, 2009 and March 31, 2014, there was a total of 177,861 injury-related hospital separations, averaging 35,572 hospital separations per year and an annual rate of 779 injury hospital separations per 100,000 population. Injury hospital separation rates varied with the measured neighbourhood area socioeconomic status variables. Injury hospital separation rates demonstrated an inverse relationship with neighbourhood levels of income and education. Neighbourhood area socioeconomic status differences were also associated with the injury hospital separation rates for falls among older adults, motor vehicle crashes involving motor vehicle occupants, pedestrians, cyclists and young drivers, and youth self-harm.ConclusionsThe study results show that neighbourhood levels of income, education and employment are associated with the risk of injury hospital separation. In particular, low education levels in FSAs was associated with increased risk of injury hospital separation, mainly for motor vehicle occupants, pedestrians, young drivers, and youth self-harm. The results of this study provide useful information for implementing injury prevention initiatives and interventions in BC to align with the provincial public health system and road safety strategy goals, particularly for identified priorities.
Highlights
This study examines social disparities across neighbourhood levels of income, education and employment in relation to overall injury hospital separations in the province of British Columbia, Canada
Three specific measures of neighbourhood area socioeconomic status (SES), namely income, education, and employment were used to define material deprivation and have been applied to identify the vulnerable areas and gaps pertaining to injury hospital separations for all injuries, and for injuries pertaining to the three British Columbia (BC) injury prevention priorities
The study results show that various mechanisms of injury have separate and different relationships with neighbourhood levels of income, education and employment
Summary
This study examines social disparities across neighbourhood levels of income, education and employment in relation to overall injury hospital separations in the province of British Columbia, Canada. The study examines the relationships of social disparities to a set of three injury prevention priorities in British Columbia, namely, transport (motor vehicle occupant, pedestrian and cyclist), falls among older adults, and youth self-harm. Injuries in British Columbia (BC) resulted in 2110 deaths, 37,207 hospital separations, 482,687 emergency room visits, 8911 permanent disabilities, and cost British Columbians $4.1 billion in healthcare related costs in 2013 (Rajabali et al 2018). Specific causes of injury have been found to vary with age, and higher incidence rates of injury hospital separations are observed for children, youth and older adults. By understanding the patterns and risk factors of injury, targeted prevention programs can be designed to reduce the burden of injury
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