Hapgood R, Kendrick D, Marsh P
Division of General Practice, University of Nottingham, Queen's Medical Centre.
J Public Health Med. 2000 Sep;22(3):307-11. doi: 10.1093/pubmed/22.3.307.
Unintentional injury is the leading cause of death in children older than 1 year. Deaths from accidents have a steeper class gradient than any other fatal condition and this inequality is widening. There are few published data on the relationship between safety practices and sociodemographic characteristics, hence this study has been undertaken to examine this relationship.
The study population comprised all parents and guardians of children aged 3-12 months in 36 practices throughout Nottingham (n = 2,152). A postal questionnaire was used to survey current childcare safety practices (from which safe practices scores were derived), together with socio-demographic variables and known risk factors for childhood unintentional injury.
Unsafe childcare practices were common. Socioeconomically disadvantaged families had more unsafe practices than more affluent families, but few parents undertook safe practices all the time. The child's age (p<0.01), ethnicity (p<0.01) and living in non-owner-occupied accommodation (p<0.01) were independently associated with the safe practices score. Multivariate regression modelling showed that these risk factors explained only 11 per cent of the variation in the safety practices score. Socio-economic factors explained more of the variation in possession and use of items of safety equipment (13 per cent) than the variation in safety behaviours with no cost implications (3 per cent).
Most of the variation in the number of safety practices is not explained by socio-demographic characteristics and further work is required to examine other possible determinants of safe practice.
意外伤害是1岁以上儿童死亡的主要原因。事故死亡的阶层梯度比任何其他致命疾病都要陡峭，而且这种不平等正在加剧。关于安全措施与社会人口统计学特征之间关系的已发表数据很少，因此开展了本研究来考察这种关系。
研究人群包括诺丁汉36家医疗机构中所有3至12个月大儿童的父母和监护人（n = 2152）。通过邮寄问卷来调查当前的儿童保育安全措施（从中得出安全措施得分），以及社会人口统计学变量和儿童意外伤害的已知风险因素。
不安全的儿童保育措施很常见。社会经济条件较差的家庭比富裕家庭有更多不安全措施，但很少有父母始终采取安全措施。孩子的年龄（p<0.01）、种族（p<0.01）以及居住在非自有住房中（p<0.01）与安全措施得分独立相关。多变量回归模型显示，这些风险因素仅解释了安全措施得分变异的11%。社会经济因素对安全设备的拥有和使用变异（13%）的解释比对无成本影响的安全行为变异（3%）的解释更多。
安全措施数量的大部分变异无法用社会人口统计学特征来解释，需要进一步开展工作来考察安全措施其他可能的决定因素。
