UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
J Epidemiol Community Health. 2012 Feb;66(2):181-8. doi: 10.1136/jech.2011.139626. Epub 2011 Oct 14.
Children from disadvantaged backgrounds are more likely to experience unintentional injuries and poor home environments. The aim of this study was to explore the home environment as a potential mediator between socioeconomic circumstances and unintentional injuries, in the UK Millennium Cohort Study (n=14 378).
RRs and 95% CIs for being injured in the home between age 9 months and 3 years were estimated according to four measures of socioeconomic circumstances: social class, maternal education, lone parenthood status and tenure. Proxy indicators of housing quality (build type, storey, garden access, rooms per capita, central heating and presence of damp) and safety equipment use (use of fireguards, safety gates, electric socket covers and smoke alarms) were then controlled for in order to observe potential mediation.
Children from routine and manual backgrounds were more likely to be injured than those from managerial and professional backgrounds (RR=1.33, 95% CI 1.21 to 1.47), as were children of lone parents (compared with couple families) (RR=1.23, 95% CI 1.12 to 1.36), those whose mothers had no educational qualifications (compared with a degree) (RR=1.42, 95% CI 1.24 to 1.63) and those living in socially rented accommodation (compared with owned/mortgaged homes) (RR=1.35, 95% CI 1.24 to 1.46). However, controlling for the indicators of housing quality and safety equipment use did not alter the elevated risk of injury experienced by children from less advantaged backgrounds.
In this contemporary UK cohort, proxy indicators of the home environment did not appear to explain socioeconomic inequalities in injuries. Research exploring alternative explanations for inequalities in injuries could help contribute to the design or adaptation of policies to reduce them.
来自弱势背景的儿童更有可能遭受意外伤害和不良的家庭环境。本研究旨在探讨家庭环境作为英国千禧年队列研究（n=14378）中社会经济状况与意外伤害之间潜在的中介因素。
根据社会阶层、母亲教育程度、单亲家庭状况和住房所有权四项社会经济状况指标，估计 9 个月至 3 岁儿童在家中受伤的相对危险度（RR）和 95%置信区间（CI）。然后控制住房质量（建筑类型、楼层、花园通道、人均房间数、中央供暖和潮湿情况）和安全设备使用（防火挡板、安全门、电插座盖和烟雾报警器）的代理指标，以观察潜在的中介作用。
与管理和专业背景的儿童相比，来自常规和体力劳动背景的儿童受伤的可能性更大（RR=1.33，95%CI 1.21 至 1.47），单亲家庭（与夫妻家庭相比）（RR=1.23，95%CI 1.12 至 1.36），母亲没有学历（与学位相比）（RR=1.42，95%CI 1.24 至 1.63）和居住在社会租赁住房（与自有/抵押贷款住房相比）（RR=1.35，95%CI 1.24 至 1.46）的儿童。然而，控制住房质量和安全设备使用的指标并没有改变弱势背景儿童受伤风险增加的情况。
在这个当代英国队列中，家庭环境的代理指标似乎并不能解释伤害方面的社会经济不平等。研究探索伤害不平等的替代解释可能有助于为减少伤害的政策的设计或调整提供依据。
