Birken Catherine S, Parkin Patricia C, To Teresa, Wilkins Russell, Macarthur Colin
Division of Pediatric Medicine, Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada.
Pediatrics. 2009 May;123(5):e815-9. doi: 10.1542/peds.2008-0132.
We sought to determine the influence of neighborhood income on homicides among children living in urban Canada.
Homicides among children <15 years of age living in any of Canada's census metropolitan areas in 1996, 1997, or 1998 were identified on the basis of vital statistics death registration data, by using International Classification of Diseases, Ninth Revision codes. Deaths were assigned to census tracts through postal codes, and the tracts were then assigned to neighborhood income quintiles on the basis of the proportions of the population below the Statistics Canada low-income cutoff values. Census population counts and intercensal population interpolations were used to estimate person-years at risk for rate calculations. Interquintile rate ratios and 95% confidence intervals were calculated. Poisson regression was used to model the effects of neighborhood income quintiles on homicide rates, after adjustment for age.
During the 3-year study period, there were 87 homicides among children <15 years of age in Canada's census metropolitan areas (0.82 cases per 100,000; not statistically different according to gender). The age-adjusted relative risks for the lowest versus highest neighborhood income quintiles were 2.95 for all children <15 years of age and 3.39 for children <5 years of age.
Effective child homicide-prevention strategies should be focused on children <5 years of age living in low-income areas.
我们试图确定社区收入对加拿大城市儿童凶杀案的影响。
利用国际疾病分类第九版编码，根据生命统计死亡登记数据，确定1996年、1997年或1998年居住在加拿大任何人口普查大都会区的15岁以下儿童的凶杀案。通过邮政编码将死亡病例分配到普查区，然后根据加拿大统计局低收入临界值以下人口的比例，将这些普查区划分为社区收入五分位数。使用普查人口计数和两次普查之间的人口插值法来估计计算发病率所需的人年数。计算五分位数间的发病率比和95%置信区间。在对年龄进行调整后，使用泊松回归模型来模拟社区收入五分位数对凶杀案发生率的影响。
在3年的研究期内，加拿大人口普查大都会区有87起15岁以下儿童凶杀案（每10万人中有0.82起；按性别无统计学差异）。所有15岁以下儿童中，收入最低与最高的社区五分位数的年龄调整相对风险为2.95，5岁以下儿童为3.39。
有效的预防儿童凶杀案策略应侧重于低收入地区的5岁以下儿童。
