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PA 08-5-2445 Inequality in unintentional childhood injuries in denmark? the influence of parental education, household income and ethnic background on injury risk

Accidents are children’s most frequent cause for contact with the public health services in Denmark. This paper examines differences in the incidence of unintentional childhood injuries involving specific injury types, mechanisms, activities and places of occurrence by socioeconomic factors to facilitate public health promotors in the municipality of Odense in their planning of preventive efforts in view of potential injury inequality. All children aged 0–15 years living in the municipality of Odense (176585) were followed in the period 2006–2010. Injury outcome was defined as a visit to the local Emergency Department. Cohort Data were transferred to Statistics Denmark and merged with socioeconomic data based on unique person identifiers (parents’ highest educational level, household income and ethnic background coded as Danish/immigrant/descendant). 27 745 injuries were analysed and the risk of injury was 1.18 (1.11–1.24) in the lowest income group compared to the highest. The lowest income group was at higher risk of fall <1 m (1.50; 1.29–1.76), fall >1 m (1.45; 1.11–1.88), injury from chemical effect (1.98; 1.28–3.08), traffic injury (2.04; 1.65–2.54) and of injury in the home and in institutions. Risk of injury among those with highest education was 0.83 (0.79–0.86) in comparison to lowest education. Higher education showed 30% and 25% higher risk of injury during exercise and on sports areas respectively, where descendants were at 33% and 30% lower risk of injury compared to Danish children. The general injury risk among immigrants and descendants was 0.75 (0.68–0.81) and 0.79 (0.76–0.82) respectively compared to Danish children and descendants were only at higher injury risk inside homes. Sociodemographic factors influenced the injury risk and the effect varied among specific injury types, mechanisms, activities and places of occurrence. The policy implication is that social background is important in establishing targeted preventive efforts, but also that some aspects of selection bias might be in place.