Rajabali Fahra, Zheng Alex, Turcotte Kate, Zhang Li Rita, Kao Diana, Rasali Drona, Oakey Megan, Pike Ian
1Department of Pediatrics, University of British Columbia, Vancouver, British Columbia Canada.
2BC Injury Research and Prevention Unit, BC Children's Hospital Research Institute, Vancouver, British Columbia Canada.
Inj Epidemiol. 2019 Jun 10;6:20. doi: 10.1186/s40621-019-0198-7. eCollection 2019.
This study examines social disparities across neighbourhood levels of income, education and employment in relation to overall injury hospital separations in the province of British Columbia, Canada. Further, the study examines the relationships of social disparities to a set of three injury prevention priorities in British Columbia, namely, transport (motor vehicle occupant, pedestrian and cyclist), falls among older adults, and youth self-harm. The goal being to better understand area-based injury incidence with a view to precision prevention initiatives, particularly for more vulnerable populations.
Acute hospital separations from the Discharge Abstract Database were identified for all causes of injury and the three BC injury prevention priorities for the period April 1, 2009 to March 31, 2014, inclusive. An ecological approach was applied where each hospital separation case was attributed with the income, education and employment level according to the injured individual's area of residence, derived from the 2011 CensusPlus data.
Injury hospital separation data were available for 191 Forward Sortation Areas in BC. Between April 1, 2009 and March 31, 2014, there was a total of 177,861 injury-related hospital separations, averaging 35,572 hospital separations per year and an annual rate of 779 injury hospital separations per 100,000 population. Injury hospital separation rates varied with the measured neighbourhood area socioeconomic status variables. Injury hospital separation rates demonstrated an inverse relationship with neighbourhood levels of income and education. Neighbourhood area socioeconomic status differences were also associated with the injury hospital separation rates for falls among older adults, motor vehicle crashes involving motor vehicle occupants, pedestrians, cyclists and young drivers, and youth self-harm.
The study results show that neighbourhood levels of income, education and employment are associated with the risk of injury hospital separation. In particular, low education levels in FSAs was associated with increased risk of injury hospital separation, mainly for motor vehicle occupants, pedestrians, young drivers, and youth self-harm. The results of this study provide useful information for implementing injury prevention initiatives and interventions in BC to align with the provincial public health system and road safety strategy goals, particularly for identified priorities.
本研究考察了加拿大不列颠哥伦比亚省社区层面的收入、教育和就业方面的社会差异与总体伤害住院病例之间的关系。此外，该研究还考察了社会差异与不列颠哥伦比亚省的三项伤害预防重点之间的关系，这三项重点分别是交通伤害（机动车驾乘人员、行人及骑自行车者）、老年人跌倒以及青少年自残。目的是更好地了解基于地区的伤害发生率，以便开展精准预防举措，特别是针对更脆弱的人群。
从出院摘要数据库中识别出2009年4月1日至2014年3月31日（含）期间所有伤害原因以及不列颠哥伦比亚省三项伤害预防重点的急性住院病例。采用生态研究方法，根据2011年增强型人口普查数据，将每个住院病例按照受伤个体的居住地区赋予相应的收入、教育和就业水平。
不列颠哥伦比亚省191个前向分拣区有伤害住院病例数据。2009年4月1日至2014年3月31日期间，共有177,861例与伤害相关的住院病例，平均每年35,572例，每10万人口的年度伤害住院率为779例。伤害住院率随所测量的社区社会经济地位变量而变化。伤害住院率与社区收入和教育水平呈负相关。社区社会经济地位差异也与老年人跌倒、涉及机动车驾乘人员、行人、骑自行车者和年轻驾驶者的机动车碰撞以及青少年自残的伤害住院率相关。
研究结果表明，社区层面的收入、教育和就业与伤害住院风险相关。特别是，前向分拣区的低教育水平与伤害住院风险增加相关，主要涉及机动车驾乘人员、行人、年轻驾驶者和青少年自残。本研究结果为在不列颠哥伦比亚省实施伤害预防举措和干预措施提供了有用信息，以符合该省公共卫生系统和道路安全战略目标，特别是针对已确定的重点。
