Relationship between socioeconomic factors and severe childhood injuries

The objective was to examine the relationship between injury rates and soci oeconomic factors for children in Hamilton County, Ohio, using small-area a nalysis. The subjects were county residents less than 15 years old who were hospitalized or died of injuries between January 1, 1993, and December 31, 1995; they were identified through a population-based trauma registry. The census tract was the unit of analysis; the rare of injury per 100,000 popu lation was the dependent variable. Risk factors included median income, lev el of education, percentage below the poverty level, percentage unemploymen t, percentage non-Caucasian, and percentage families headed by females. The re were 2,437 children meeting the case definition; injuries per census tra ct ranged from 0 to 2,020.2 per 100,000 per year. Census tracts with higher injury rates had lower median incomes, more people with less than a high s chool education, more unemployment, more families headed by females, more p eople living below the poverty level, and more non-Caucasians than those wi th lower rates. In a regression model, percentage of people living below th e poverty level, percentage of those who did not graduate from high school, and percentage unemployment were significant risk factors for injuries, P < .001. Since small-area analysis examines associations on an ecological le vel rather than an individual level, these studies should always be interpr eted with caution because an association found at the level of the census t ract may nor apply at the individual level. Interventions to reduce injurie s should target socioeconomically disadvantaged children living below the p overty level and those in areas with fewer high school graduates and more u nemployment.