Abstract
Objectives
The purposes of this study are to a) determine the extent to which individual and neighbourhood-level socio-economic indicators broadly reflect the social conditions associated with assault injuries within an urban Canadian city, b) examine the significance of this relationship and c) determine if this relationship is best explained at the individual or neighbourhood scale.
Methods
Assault-related hospitalization data (2001-2006) were obtained from the British Columbia Trauma Registry (BCTR). Data from the 2001 Census were used as proxy measures of individual and neighbourhood socio-economic status (SES). A generalized hierarchical nonlinear model was used to differentiate between individual and neighbourhood effects.
Results
A social gradient according to individual and neighbourhood SES and frequency of assault injuries was observed for adults of all ages. After controlling for age and individual SES, probability of greater risk of assault injury among individuals living in progressively less privileged neighbourhoods remained 1.5-3 times higher than individuals living in the least deprived neighbourhoods. For adults under the age of 35, neighbourhood SES was a more statistically significant indicator of increased odds of assault injury than individual income.
Discussion
Assessing compositional and contextual variations in health outcomes provides health researchers engaged in injury surveillance a way of showing how, and for which type of people, neighbourhood environments influence the likelihood that an individual will be hospitalized due to an intentional injury. This analysis suggests that prevention efforts exclusively focused on the individual may have a limited effect in reducing the occurrence of assault-related injuries, especially among young adults.
Key words: Injuries, socioeconomic factors, residential characteristics, public health
Résumé
Objectifs
Cette étude vise à: a) déterminer s’il existe une correspondance générale entre les indicateurs socioéconomiques individuels et par quartier et les conditions sociales associées aux blessures par suite d’agressions dans une grande ville canadienne, b) examiner l’importance de cette correspondance et c) déterminer si cette correspondance s’explique le mieux à l’échelle individuelle ou du quartier.
Méthode
Les données sur les hospitalisations des victimes d’agressions (2001-2006) ont été extraites du registre des traumatismes de la Colombie-Britannique (BCTR). Les données du Recensement de 2001 ont servi de variables substitutives au statut socioéconomique (SSE) individuel et par quartier. Un modèle hiérarchique non linéaire généralisé a servi à différencier les effets individuels des effets du quartier.
Résultats
Nous avons observé, pour les adultes de tout âge, un gradient social selon le SSE individuel et du quartier et la fréquence des blessures par suite d’agressions. Compte tenu de l’âge et du SSE individuel, la probabilité d’un risque plus élevé de blessure par suite d’agression chez les personnes vivant dans des quartiers progressivement moins privilégiés demeurait de 1,5 fois à 3 fois plus élevée que chez les personnes vivant dans les quartiers les moins démunis. Chez les adultes de moins de 35 ans, le SSE du quartier était un indicateur plus significatif d’une probabilité accrue de blessure par suite d’agression que le revenu personnel.
Discussion
L’évaluation des écarts compositionnels et contextuels dans les résultats cliniques offrent aux chercheurs médicaux qui s’intéressent à la surveillance des blessures un moyen de montrer comment, et pour quels types de personnes, l’environnement du quartier influence la probabilité qu’une personne soit hospitalisée à la suite d’une agression. Cela pourrait vouloir dire que les efforts de prévention qui s’adressent exclusivement aux individus n’ont qu’un effet limité pour réduire la fréquence des blessures par suite d’agressions, surtout chez les jeunes adultes.
Mots clés: blessures, facteurs socioéconomiques, caractéristiques résidentielles, santé publique
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