An ecologic study of poverty and childhood injury in the Kingston Region

by Faelker, Taron Matthew

An ecologic study was used to investigate associations between poverty and the occurrence of non-fatal childhood injury in the Kingston Region of Ontario, Canada. Data fiom the Kingston and Region Injury Surveillance Program, the Canada Census of Population and patient records from two local hospitals were Iinked at the enumeration area level. Children between O and 19 years of age were divided into five categories of poverty based on the proportion of low-income individuals in their enumeration area of residence. Rates of injury were calculated for each category of low incorne and multiple Poisson regression analysis was used to assess the association between low income and injury, while simultaneously adjusting for the effects of multiple covanates. There were 5894 injuries identified in the one-year study period for 35,380 children living in 175 enumeration areas. Analysis revealed statistically higher rates of injury for children living in areas with a higher proportion of low-income individuals. This observation was consistent for the total occurrence of injury overall, arnong males and females, four age groups (0-4, 5-9 10- 14 and 15-19 years) and several specific injury outcornes. Statistically significant associations remained afier adjustment for important covariates. The adjusted rate ratio comparing the overall incidence of injury among children living in areas with the highest proportion of low-income individuals to children living in areas with the lowest proportion was 1.67 (95% C.I. 1.48- 1.89). The association was stronger for males compared to females and for children between 15 and 19 yeae of age compared to children in other age goups. These results have implications for research, surveillance and public health propms and may heip improve injury prevention and control efforts in this cornmunity and other areas.