Abstract
Objective: To explore urban-rural differences in the mortality and hospital admission rates for unintentional injuries in the Republic of Ireland.
Design: Standardised mortality ratios (SMRs) in residents of urban and non-city areas (called rural areas) from all causes of unintentional injury were calculated using Central Statistics Office mortality data from 1980–2000. Hospital admission data (Hospital In-Patient Enquiry) from 1993–2000 were used to calculate standardised hospital admission ratios (SARs) in urban and rural residents. Population data were obtained from the 1981, 1986, 1991, and 1996 censuses.
Results: The rate of unintentional injury mortality was significantly higher in rural residents for all-cause unintentional injury mortality (SMR 103.0, 95% confidence interval 101 to 105), and specifically for deaths related to motor vehicle trauma (MVT), drowning, machinery, and firearms. There were significantly higher SMRs in urban residents for falls and poisoning. The rate of unintentional injury hospital admission was significantly higher in rural residents for all-cause unintentional injury (SAR 104.6, 95% confidence interval 104 to 105) and specifically for injuries from falls, MVT, being struck by or against an object, injuries in pedal cyclists, fire/burn injuries, and machinery injuries. SARs were significantly higher in residents of urban areas for poisoning and injuries in pedestrians.
Conclusions: There are urban-rural differences in mortality and admissions for injuries in Ireland. Possible reasons for the higher rural mortality rates are higher case fatality in MVT and rural exposure to hazardous farm machinery, firearms, and open areas of water. This information could assist in targeting prevention programmes under the proposed National Injury Prevention Strategy.
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Selected References
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- Boufous S., Williamson A. Reporting of the incidence of hospitalised injuries: numerator issues. Inj Prev. 2003 Dec;9(4):370–375. doi: 10.1136/ip.9.4.370. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cameron D., Bishop C. Farm accidents in adults. BMJ. 1992 Jul 4;305(6844):25–26. doi: 10.1136/bmj.305.6844.25. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cummings P., Koepsell T. D., Mueller B. A. Methodological challenges in injury epidemiology and injury prevention research. Annu Rev Public Health. 1995;16:381–400. doi: 10.1146/annurev.pu.16.050195.002121. [DOI] [PubMed] [Google Scholar]
- Jacobsen P. L. Safety in numbers: more walkers and bicyclists, safer walking and bicycling. Inj Prev. 2003 Sep;9(3):205–209. doi: 10.1136/ip.9.3.205. [DOI] [PMC free article] [PubMed] [Google Scholar]
- MacWilliam L., Mao Y., Nicholls E., Wigle D. T. Fatal accidental childhood injuries in Canada. Can J Public Health. 1987 Mar-Apr;78(2):129–135. [PubMed] [Google Scholar]
- Miles-Doan R., Kelly S. Inequities in health care and survival after injury among pedestrians: explaining the urban/rural differential. J Rural Health. 1995 Summer;11(3):177–184. doi: 10.1111/j.1748-0361.1995.tb00413.x. [DOI] [PubMed] [Google Scholar]
- Page Y. A statistical model to compare road mortality in OECD countries. Accid Anal Prev. 2001 May;33(3):371–385. doi: 10.1016/s0001-4575(00)00051-8. [DOI] [PubMed] [Google Scholar]
- Rivara F. P., Aitken M. Prevention of injuries to children and adolescents. Adv Pediatr. 1998;45:37–72. [PubMed] [Google Scholar]
- Rogers F. B., Shackford S. R., Hoyt D. B., Camp L., Osler T. M., Mackersie R. C., Davis J. W. Trauma deaths in a mature urban vs rural trauma system. A comparison. Arch Surg. 1997 Apr;132(4):376–382. doi: 10.1001/archsurg.1997.01430280050007. [DOI] [PubMed] [Google Scholar]
- Scallan Elaine, Staines Anthony, Fitzpatrick Patricia, Laffoy Marie, Kelly Alan. Unintentional injury in Ireland: a comparison of mortality and morbidity data. J Public Health (Oxf) 2004 Mar;26(1):6–7. doi: 10.1093/pubmed/fdh107. [DOI] [PubMed] [Google Scholar]
- Street J. T., Winter D., Buckley S., Nicholson P., Twomey A. Trauma on rural roads: the role of a peripheral hospital. Injury. 1999 Jun;30(5):337–340. doi: 10.1016/s0020-1383(99)00093-5. [DOI] [PubMed] [Google Scholar]
- Waller A. E., Baker S. P., Szocka A. Childhood injury deaths: national analysis and geographic variations. Am J Public Health. 1989 Mar;79(3):310–315. doi: 10.2105/ajph.79.3.310. [DOI] [PMC free article] [PubMed] [Google Scholar]