Understanding pathways to social inequalities in childhood unintentional injuries: findings from the UK Millennium Cohort Study

Campbell, Melisa; Lai, Eric TC; Pearce, Anna; Orton, Elizabeth; Kendrick, Denise; Wickham, Sophie; Taylor-Robinson, David C

Abstract

Background: Childhood unintentional injuries (UI) are common but continue to happen more often to children living in less advantaged socioeconomic circumstances (SEC). Our aim was to explore how early life factors mediate the association between SEC and UIs, using the UK Millennium Cohort Study.

Methods: We calculated risk ratios (RR) and 95% confidence intervals (95%CI) for parental report of UI occurring between age 3 and 5 years, using Poisson regression according to family income as a measure of SEC. We explored potentially mediating pathways by controlling associations between SEC and UI for groups of early life risks in three domains: factors that may influence environmental safety, supervision and the MCS child’s abilities and behaviours.

Results: Twenty eight percent of children had a UI from 3 to 5 years old. Children from the lowest income quintile were more likely to be injured compared to those from the highest (RR 1.20 95%CI 1.05, 1.37). Sequentially controlling for early life factors that may influence environmental safety (RR 1.19 95%CI 1.02, 1.38), then supervision (RR 1.18, 95%CI 1.02, 1.36), and finally adding child’s behaviour and abilities (RR 1.15, 95%CI 1.00, 1.34) into the model reduced the RR by 5%, 10% and 25% respectively.

Conclusions: Addressing factors that may influence environmental safety and supervision, and the child’s abilities and behaviours only partly explains the increased UI risk between the highest and lowest income quintiles. Further research is required to explore factors mediating associations between SEC and specific mechanisms and types of injuries.

Citation

Campbell, M., Lai, E. T., Pearce, A., Orton, E., Kendrick, D., Wickham, S., & Taylor-Robinson, D. C. (2019). Understanding pathways to social inequalities in childhood unintentional injuries: findings from the UK Millennium Cohort Study. BMC Pediatrics, 19, Article 150. https://doi.org/10.1186/s12887-019-1514-7

• Journal Article Type: Article
• Acceptance Date: Apr 16, 2019
• Online Publication Date: May 15, 2019
• Publication Date: May 15, 2019
• Deposit Date: Apr 29, 2019
• Publicly Available Date: May 21, 2019
• Journal: BMC Pediatrics
• Electronic ISSN: 1471-2431
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 19
• Article Number: 150
• DOI: https://doi.org/10.1186/s12887-019-1514-7
• Keywords: unintentional injuries; inequalities; socioeconomic; longitudinal; cohort; child health.
• Public URL: https://nottingham-repository.worktribe.com/output/1849126
• Publisher URL: https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-019-1514-7
• Additional Information: Received: 2 August 2018; Accepted: 16 April 2019; First Online: 15 May 2019; : The Millennium Cohort Study was approved by the South West and London Multi Centre Research Ethics Committees. Referenced as MREC/01/6/19, MREC/03/2/022, 05/MRE02/46 for sweeps one, two and three respectively [CitationRef removed]. The present analyses did not require additional ethics approval.The Millennium Cohort Study obtained informed written consent from parent/ guardians of the cohort children in order to participate in the study and other participants as necessary [CitationRef removed]. The present analyses did not require additional consent approval.; : Not applicable.; : The authors have no financial relationships relevant to this article and no conflicts of interest to disclose.; : Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
• Contract Date: May 21, 2019