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177 How to choose who to focus on? National study to identify risk groups for child injury

Background Identifying populations at high risk for injury is a key step in developing effective strategies to reduce overall burden of injuries and gaps in injury rates between different segments of the population. This need is even more pressing in times of economic crises. Israel’s population is diverse representing different ethnic, socio-economic, religious and cultural groups. Comparing child injury risks among different segments of the Israeli population enables us to identify high risk groups and their proportion of injury burden. Methods Child population in Israel was divided into 27 groups based on cultural and ethnic affiliation (Jews, Arabs, Haredi, and Bedouin), socio-economic status (SES), age group and region based on municipal level data. We calculated the rate of child injury per group using mortality and hospitalisation data. The relative proportion of each group’s injury burden to maximise the impact of future targeted interventions was calculated. Finally, we used cluster analysis to rank each group into one of four injury risk groups. Results Bedouin children of low SES aged 0–4 years, in the southern region, were identified as top priority for intervention (mortality rate of 29.3 per 100,000, hospitalisation rate 807.8 days per 10,000). This group is 1.0% of the child population yet carries 8.3% of the mortality burden. The lowest priority cluster, constituting 85% of the child population includes the entire Jewish population at all SES levels as well as a minority of the Arab children (mortality rate of 2.5 per 100,000). Conclusions This study points at young Bedouin children as the highest risk group for injuries in Israel. Based on these findings they have been targeted for prevention efforts by national and local authorities for 2016–2020. Focusing on feasible, cost-effective, proven, and tailored interventions for at risk populations, in cooperation with community leaders, may achieve considerable and lasting improvement in safety.