Department of Public Health Sciences, Division of Global Health/IHCAR, Karolinska Institutet, , Stockholm, Sweden.
Inj Prev. 2013 Oct;19(5):311-5. doi: 10.1136/injuryprev-2012-040624. Epub 2013 Feb 12.
Adverse living standards are associated with poorer child health and safety. This study investigates whether adverse housing and neighbourhood conditions contribute to explain country-level associations between a country's economic level and income inequality and child mortality, specifically injury mortality.
Ecological, cross-sectional study.
SETTING/SUBJECTS: Twenty-six European countries were grouped according to two country-level economic measures from Eurostat: gross domestic product (GDP) and income inequality. Adverse country-level housing and neighbourhood conditions were assessed using data from the 2006 European Union Income Social Inclusion and Living Conditions Database (n=203 000).
Child mortality incidence rates were derived for children aged 1-14 years for all causes, all injuries, road traffic injuries and unintentional injuries excluding road traffic. Linear regression analysis was applied to measure whether housing or neighbourhood conditions have a significant association with child mortality and whether a strain modified the association between GDP/income inequality and mortality.
Country-level income inequality and GDP demonstrated a significant association with child mortality for all outcomes. A significant association was also found between housing strain and all child mortality outcomes, but not for neighbourhood strain. Housing strain partially modified the relationship between income inequality and GDP and all child mortality outcomes, with the exception of income inequality and road traffic injury mortality showing full mediation by housing strain.
Adverse housing conditions are a likely pathway in the country-level association between income inequality and economic GDP and child injury mortality.
不良生活水平与儿童健康和安全状况较差有关。本研究调查住房和社区条件较差是否有助于解释一个国家的经济水平和收入不平等与儿童死亡率（特别是伤害死亡率）之间的国家间关联。
生态、横断面研究。
地点/对象：根据来自 Eurostat 的两项国家经济衡量指标，将 26 个欧洲国家分为两组：国内生产总值（GDP）和收入不平等。使用 2006 年欧盟收入社会包容和生活条件数据库的数据评估不利的国家层面住房和社区条件（n=203000）。
计算所有原因、所有伤害、道路交通伤害和非道路交通伤害的 1-14 岁儿童死亡率发生率。应用线性回归分析来衡量住房或社区条件是否与儿童死亡率有显著关联，以及压力是否会改变 GDP/收入不平等与死亡率之间的关联。
国家层面的收入不平等和 GDP 与所有结果的儿童死亡率显著相关。住房压力也与所有儿童死亡率结果显著相关，但与社区压力无关。住房压力部分改变了收入不平等和 GDP 与所有儿童死亡率结果之间的关系，除了收入不平等和道路交通伤害死亡率完全由住房压力介导。
不良住房条件可能是收入不平等和经济 GDP 与儿童伤害死亡率之间国家间关联的一个途径。
