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Children at risk in traffic: improvement potentials in the Swedish context
1Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden. marie.hasselberg@smd.sll.se
Insights
Swedish children face higher risks of road traffic injuries, particularly as car passengers and pedestrians, linked to socioeconomic factors. Addressing these disparities is crucial for improving child road safety.
Area of Science:
- Pediatric injury prevention
- Public health research
- Road safety epidemiology
Background:
- Road traffic injuries (RTIs) represent a significant public health concern for children globally.
- Socioeconomic factors are known to influence health outcomes, including injury risk.
- Understanding the distribution of RTIs across different road user categories and socioeconomic strata is vital for targeted interventions.
Purpose of the Study:
- To investigate the social distribution of road traffic injury (RTI) risk among Swedish children.
- To identify potential improvements in child road safety by analyzing risks across pedestrian, bicyclist, and car passenger categories.
- To examine the influence of socioeconomic position on RTI risk in children.
Main Methods:
- A population-based cohort study utilizing Swedish national registers (Census 1990, Hospital Discharge Register 1991-1999).
- Inclusion of children aged 1-14 years, focusing on injuries sustained as pedestrians, bicyclists, or car passengers.
- Socioeconomic position assessed via social class, education, and disposable income, with relative risks calculated using Poisson regression.
Main Results:
- Children of farmers and the self-employed showed increased risk as car passengers.
- Children of unskilled workers had a higher risk of pedestrian injuries.
- Family disposable income was associated with the highest population-attributable risks for pedestrian and car passenger injuries (19-20%).
Conclusions:
- Children's vulnerability in traffic situations necessitates tailored safety measures.
- Significant improvements in child road safety are achievable by considering their developmental stage.
- There is a critical need to integrate equity into road traffic safety strategies to reduce socioeconomic disparities in injury risk.
Aim:
To investigate the social risk distribution and improvement potentials for road traffic injuries among Swedish children by considering three categories of road users.
Methods:
A population-based cohort study of children aged 1-14 y was carried out. Subjects were taken from the Swedish Population and Housing Census of 1990 (n = 1406405), and followed-up in the National Hospital Discharge Register for the years 1991-1999 focusing on injuries incurred as pedestrians, bicyclists or car passengers (n = 16084). Household socio-economic position was measured using social class, education and disposable income. Relative risks were calculated using Poisson regression for each measure of socio-economic position and by combining them, adjusting for sex, age of child and age of mother at delivery. Population-attributable risks were compiled for each category of road user and each measure of socio-economic position.
Results:
Children of farmers and the self-employed are at greater risk for injuries as car passengers (RR 2.40, CI 1.79-3.20 and RR 1.44, CI 1.16-1.79, respectively), but not for pedestrian- and bicycle-related injuries. Children of unskilled workers are at greater risk for pedestrian injuries (RR 1.39, CI 1.15-1.67). Controlling for education and disposable income did not affect the relative risks to the same extent according to the social class and category of road user. The highest population-attributable risks were related to family disposable income and were indicated for pedestrians and car passengers (19-20%).
Conclusion:
By taking children's limited ability to deal with different types of traffic situations into consideration, considerable improvements in children's risk levels have been observed. Now there is a need to add equity in the road traffic safety equation.
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