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Relationships between child, family and neighbourhood characteristics and childhood injury: A cohort study

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  • Kendrick, Denise
  • Mulvaney, Caroline
  • Burton, Paul
  • Watson, Michael

Abstract

There has been little research into the role of neighbourhood effects in childhood injury. We report results from a cohort study, comprising 1717 families (2357 children aged 0-7 years) registered at 47 general practices in Nottingham, UK. Multi-level Poisson regression examined relationships between electoral ward (neighbourhood), family and child characteristics and medically attended injury rates. Primary care attendance rates were higher for children in rented accommodation and those aged 2-3 years. An n-shaped relationship was found between geographical access to services and the primary care attendance rate. Accident and Emergency (A&E) department attendance rates were higher amongst boys, children in rented accommodation, with a teenage mother, aged 2-5 years and living in wards with a higher number of parks and play areas. They were lower for children whose families had a smoke alarm. Hospital admission rates were higher amongst children living in more deprived wards and wards with higher violent crime rates. They were lower in children whose families had smoke alarms, stair gates and stored sharp objects safely. Primary care and A&E attendance rates varied significantly between families. Variation between wards in the A&E attendance rate was explained by family characteristics. We conclude that characteristics of wards, families and children are associated with medically attended childhood injury rates. This study did not find a neighbourhood effect for A&E attendances that could not be explained by family level characteristics. Studies with greater power and a measure of injury severity independent of health service utilisation are needed to explore the relationship between neighbourhood effects and more severe injuries. The greater variation in injury rates vary between families than between neighbourhoods suggests reducing inequalities in injury rates may be achieved more effectively by focussing prevention at families rather than neighbourhoods, but in practice interventions at both levels are likely to be necessary.

Suggested Citation

  • Kendrick, Denise & Mulvaney, Caroline & Burton, Paul & Watson, Michael, 2005. "Relationships between child, family and neighbourhood characteristics and childhood injury: A cohort study," Social Science & Medicine, Elsevier, vol. 61(9), pages 1905-1915, November.
    • Handle: RePEc:eee:socmed:v:61:y:2005:i:9:p:1905-1915
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    References listed on IDEAS

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    1. Reading, Richard & Langford, Ian H. & Haynes, Robin & Lovett, Andrew, 1999. "Accidents to preschool children: comparing family and neighbourhood risk factors," Social Science & Medicine, Elsevier, vol. 48(3), pages 321-329, February.
    2. Diez Roux, A.V., 2001. "Investigating neighborhood and area effects on health," American Journal of Public Health, American Public Health Association, vol. 91(11), pages 1783-1789.
    3. Duncan, Craig & Jones, Kelvyn & Moon, Graham, 1998. "Context, composition and heterogeneity: Using multilevel models in health research," Social Science & Medicine, Elsevier, vol. 46(1), pages 97-117, January.
    4. Haynes, Robin & Reading, Richard & Gale, Susan, 2003. "Household and neighbourhood risks for injury to 5-14 year old children," Social Science & Medicine, Elsevier, vol. 57(4), pages 625-636, August.
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    1. Sha Ma & Minmin Jiang & Feng Wang & Jingjing Lu & Lu Li & Therese Hesketh, 2019. "Left-Behind Children and Risk of Unintentional Injury in Rural China—A Cross-Sectional Survey," IJERPH, MDPI, vol. 16(3), pages 1-9, January.
    2. Reading, Richard & Jones, Andrew & Haynes, Robin & Daras, Konstantinos & Emond, Alan, 2008. "Individual factors explain neighbourhood variations in accidents to children under 5 years of age," Social Science & Medicine, Elsevier, vol. 67(6), pages 915-927, September.
    3. Elizabeth Orton & Denise Kendrick & Joe West & Laila J Tata, 2012. "Independent Risk Factors for Injury in Pre-School Children: Three Population-Based Nested Case-Control Studies Using Routine Primary Care Data," PLOS ONE, Public Library of Science, vol. 7(4), pages 1-8, April.
    4. Antti O. Tanskanen & Mirkka Danielsbacka, 2017. "Association Between Grandparental Co-Residence and Early Childhood Injury in the UK," Child Indicators Research, Springer;The International Society of Child Indicators (ISCI), vol. 10(3), pages 825-837, September.

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