Table 5.
Individual-level studies for childhood burn, fall, poisoning, and drowning injuries: summary of methodological features and results (n = 11).
| Author & year country (city/region) | Outcome/s b, F, P, Da | Age group/s data sourceb | SES measure | Analysis covariates | Results: the level of 95% is used for all confidence intervals (CI) |
|---|---|---|---|---|---|
| Cho et al. 2007 South Korea (whole country) | D Deaths, stratified by sex and age group | 10–14 and 15–19 years R: death register, health insurance beneficiary dataset | Parental income (based on insurance contribution - 3 levels) | Cox proportional hazards model None | Drowning deaths showed no socioeconomic gradient among boys or girls for either age group (eg, for boys 10–19 years RR = 1.26, CI 0.82–1.92, p for trend = 0.28, lowest compared to highest income tertile) |
| Delgado et al. 2002 Peru (Lima) | B Hospitalisations (all burn types) | 0–17 years Q: structured questionnaire with guardians | Household income (2 levels), crowding (2 levels), maternal education (2 levels) | Logistic regression (case-control study) No water supply, living room in house, own house, patient is not child of household head | Children in low income (OR=2.8; CI 2.0–3.9) and crowded (OR=2.5; CI 1.7–3.6) households have increased risk of burn injuries compared to those in households with higher income and no crowding; children of mothers with at least a high school education have lower risks compared to those with mothers without this education (OR=0.6; CI 0.5–0.9) |
| Donroe et al. 2009 Peru (Lima) | P, B, F Severe enough to require medical consultation | 0–18 years I: household survey with guardian or with child if aged ≥12 years | Poverty (2 levels), parental education (2 levels) | Logistic regression Sex, age, other SES, overcrowding, number of children in the home | No association between SES and individual injury in multivariate model but increased odds of falls for children who are from homes that are both poor and with low parental education (OR=1.30; CI 1.0–1.7). Children in poor households had increased odds of burn injuries (adjusted OR=1.34; CI 1.0–1.8) compared to those in more affluent households |
| Edwards et al. 2006 United Kingdom (England and Wales) | B Deaths from exposure to smoke, fire, and flames | 0–15 years R: population-based death register | Family occupational status (8 levels) | Death rates (95% CI) None | Children from family with the least favourable occupational status had 37.7 (CI 11.6–121.9) times higher death rates than those from the most favourable one |
| Engström et al. 2002 Sweden (whole country) | F Hospitalisations and deaths combined, stratified by age | 0–4, 5–9, 10–14 and 15–19 years R: linkage of health, death and census records | Parental social class (4 levels) | Logistic regression, slope index of inequality, relative index of inequality Parents' country of birth, single parent home, receipt of welfare benefits | No association between SES and risk of fall injuries except among 0–4 year olds (RR = 1.08; CI 1.0–1.1 for children both of unskilled and skilled workers compared with children of intermediate and high level employees) |
| Forjuoh et al. 1995 Ghana (Ashanti region) | B Injuries with evidence of physical scar | 0–5 years I: household survey of caretakers | Maternal education (2 levels) | Logistic regression (case-control study) Presence of pre-existing impairment in child, history of sibling burn, storage of flammable substance in home | Maternal education was not significantly associated with childhood burns (OR=0.76, CI 0.55–1.05 for educated mother compared to a mother without education) |
| Giashuddin et al. 2009 Bangladesh (randomly selected areas of whole country) | D Deaths and nonfatal injuries separately | 1–4 years I: household survey | Assets Index (quintiles) | Concentration index | Drowning morbidity and mortality were 3.8 and 7.0 times higher, respectively, in the least as compared the most deprived quintile. Concentration indices −.21 and −.28, respectively) showed significant inequalities among the groups (P < .05) |
| Gilbride et al. 2006 Canada (Alberta province) | P, B Cases requiring physician consultation | 0–17 years R: administrative health database | Receipt of healthcare premium subsidy (as proxy for low SES – 2 levels) | Logistic regression Sex, age | Compared to children from families without subsidies, those from low SES families had higher odds of burns (OR=1.35; CI 1.3–1.4) and poisoning (OR=1.60; CI 1.5–1.7) |
| Laursen & Nielson 2008 Denmark (whole country) | P, B, F Injuries occurring at home and seen in emergency department. Falls: from ≥1 metre | 0–14 years R: national injury register | Parents' education (3 levels), and income (4 levels) | Poisson regression Age, sex, distance from hospital, number of children, age at childbirth, family type, crowding, dwelling type | Increasing injury with decreasing SES for each cause. Compared to children of parents with a tertiary education, those of parents with a primary school education had higher risks of poisoning (RR = 1.9; CI 1.6–2.3), burns (RR = 1.6; CI 1.4–1.9) and high falls (RR = 1.4; CI 1.2–1.7). Compared to children of parents in the most affluent group, those of parents in the lowest income group had higher risks of poisoning (RR = 1.7; CI 1.4–2.1), burns (RR = 1.9; CI 1.6–2.3) and high falls (RR = 1.2; CI 1.0–1.4) |
| Roberts 1997 United Kingdom (England and Wales) | P, B, F Deaths | 0–15 years R: death register | Social class of father (6 levels) | Poisson regression None | Mortality differentials were steepest for fire-related deaths (OR=1.89; CI 1.8–2.0), followed by falls (OR=1.46; CI 1.3–1.6) and poisoning (OR=1.36; CI 1.1–1.6) |
| Scholer 1998 United States (State of Tennessee) | B House fires resulting in at least one fatality | 0–5 years R: linkage of birth certificates, census data & death certificates | Maternal education (4 levels), neighbourhood income (5 levels) | Poisson regression (cohort study) Maternal age, race, marital status, residence, number of children, first prenatal care visit, child sex & gestational age | Low maternal education was positively associated with an increased risk of fatal fire events (RR = 19.36; CI 2.6–142.4 for <12 years education compared to ≥16 years). The association between neighbourhood income and injury did not persist in the multivariate analysis |
Note aB=burns, F=falls, P=Poisoning, D=Drowning; bR=register; I= interview, Q=self-administered questionnaire.