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Study: Neighbourhood variation in hospitalization for unintentional injury among children and teenagers

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2001/2002 to 2004/2005

Children aged 9 and under living in lower-income urban neighbourhoods were more likely than those in higher-income neighbourhoods to be hospitalized for unintentional injuries between 2001/2002 and 2004/2005.

This was particularly the case for hospitalizations due to injuries related to land transportation, poisoning, fire, drowning/suffocation, or being cut or pierced.

The association between living in a lower-income neighbourhood and hospitalization rates was weaker for young people aged 10 to 19.

In fact, young people in this age group who lived in higher-income neighbourhoods had higher hospitalization rates as a result of being struck than did their counterparts in lower-income neighbourhoods. Such injuries would include being struck by sports equipment, thrown objects or by other people, for example.

Rates higher for males

During the four-year period, there were 76,227 hospitalizations for unintentional injuries among children and teens in urban areas.

Males accounted for two-thirds of these hospitalizations. The crude hospitalization rate for males was 40.8 hospitalizations for every 10,000 person-years at risk, well above the rate of 21.6 for females.

Crude rates tended to rise with age. Rates went from about 30 hospitalizations for every 10,000 person-years at risk for children younger than 10 to almost 35 among youth aged 15 to 19.

Note to readers

Childhood injury has been identified as a key health policy area in Canada. The study, "Neighbourhood variation in hospitalization for unintentional injury among children and teenagers," used national hospital data to examine relationships between neighbourhood income in urban areas and hospitalization for unintentional injury among children and teenagers.

The study examined acute-care inpatient hospitalization discharge records from 2001/2002 through 2004/2005 for children up to age 19. Injuries were classified using the International Classification of Diseases.

The study used Census Dissemination Areas as neighbourhood proxies, and calculated income quintiles from the 2001 Census.

Age-standardized rates of hospitalization per 10,000 person-years at risk were calculated for each type of injury, by sex, age group and neighbourhood income quintile.

Falls were the leading cause, accounting for 43% of unintentional injury hospitalizations, followed by land transportation, accounting for 21%. Another 11% resulted from being struck. Relatively few hospitalizations were attributable to poisoning, cuts or piercing, fire, natural environment, or drowning/suffocation.

Hospitalization rates and neighbourhood income

Because of differences in the age distribution of the population of children and teens across neighbourhood income levels, hospitalization rates for unintentional injuries were age-standardized. Rates fell from about 33 hospitalizations for every 10,000 person-years at risk in the lowest income neighbourhoods to about 30 per 10,000 person-years at risk in the highest.

This pattern applied to males and females and to children younger than 10. Among youth aged 10 to 19, associations between neighbourhood income and all-cause unintentional injury hospitalizations were not statistically significant.

For several specific causes of unintentional injury, children and teens in low-income neighbourhoods were more likely to be hospitalized than were their counterparts in high-income neighbourhoods.

Age-standardized hospitalization rates for poisoning and for being cut or pierced were significantly higher in the lowest-income neighbourhoods than in the highest. Similarly, hospitalization rates for injuries caused by fires tended to rise as neighbourhood income fell.

For injuries due to drowning/suffocation, land transportation and falls, hospitalization rates for children, but not teens, rose steadily at successively lower levels of neighbourhood income.

By contrast, young people aged 10 to 19 in the lowest-income neighbourhoods had a significantly lower rate of hospitalization for falls than did those in the highest income neighbourhoods.

As well, at ages 10 to 19, age-standardized rates of hospitalization due to being struck tended to rise with neighbourhood income.

Definitions, data sources and methods: survey number 3203.

The article, "Neighbourhood variation in hospitalization for unintentional injury among children and teenagers," which is part of today's online edition of Health Reports, Vol. 21, no. 4 (82-003-X, free), is now available from the Key resource module of our website under Publications. For more information about this article, contact Lisa Oliver (613-951-4708;, Health Analysis Division.

Today's release of Health Reports includes two other articles.

"Combining nutrient intake from food/beverages and vitamin/mineral supplements" describes methods for combining food and supplement intake of a given nutrient, as reported to the 2004 Canadian Community Health Survey: Nutrition. For more information about this article, contact Didier Garriguet (613-951-7187;, Health Analysis Division.

"Socio-economic status and vitamin/mineral supplement use in Canada" examines factors related to Canadians' use of vitamin/mineral supplements, with emphasis on associations with household income and education. For more information about this article, contact Hassanali Vatanparast (306-966-6341;, University of Saskatchewan.

For more information about Health Reports, contact Janice Felman (613-951-6446;, Health Analysis Division.