Injury and health among children in vulnerable families
Lakshmi Sridharan1, Marie Crandall
1Division of Trauma & Critical Care, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
Insights
Children in vulnerable families face higher injury risks. At age 5, male gender and low income significantly predict childhood injury, highlighting the need for targeted interventions.
Area of Science:
- Pediatric injury prevention
- Social determinants of child health
- Epidemiology of childhood injury
Background:
- Childhood injury is a leading cause of death for children over one year old.
- Socioeconomic factors like income and family violence significantly influence childhood injury rates.
- This study examines injury incidence in a cohort of vulnerable 5-year-old children.
Purpose of the Study:
- To determine the incidence of injury among 5-year-old children in a cohort of vulnerable families.
- To identify independent risk factors for childhood injury at age 5 within this population.
Main Methods:
- Utilized data from the Fragile Families and Child Wellbeing Study, a longitudinal cohort of ~5,000 at-risk US families.
- Employed multivariate regression analysis on mother interviews and follow-up surveys at ages 1, 3, and 5.
- Analyzed 5-year follow-up data from 2,397 families to identify injury predictors.
Main Results:
- The incidence of injury at age 5 was 12.3% (296 out of 2,397 children).
- Multivariate regression identified male gender (OR, 2.62) and lowest income stratum (OR, 1.23) as significant predictors of injury.
- These findings indicate a higher incidence compared to the CDC's general risk for 5-year-olds (9.3%).
Conclusions:
- Vulnerable children exhibit a persistently elevated risk of injury.
- At school age, low household income and male gender emerge as key risk factors for injury.
- Findings suggest the need for gender-specific considerations and targeted interventions for caregivers and environments.
Background:
Injury is the leading cause of death for children older than 1 year. The incidence of childhood injury varies greatly depending on social factors, including income, family violence, and other social stressors. This study reports the incidence of injury among children aged 5 years in a cohort of vulnerable families.
Methods:
The Fragile Families and Child Wellbeing Study is a longitudinal cohort of approximately 5,000 at-risk families across the United States. Data from interviews with mothers conducted shortly after giving birth and follow-up surveys at 1 year, 3 years, and 5 years were used. Multivariate regression analysis was used to identify independent risk factors for injury in year 5.
Results:
Five-year follow-up data on injury was complete for 2,397 families. Two hundred ninety-six children were injured at the age of 5 years (12.3%). Multivariate regression found that the strongest predictors of injury in year 5 were male gender (OR, 2.62; 95% CI, 1.02-6.75; p = 0.04) and being in the lowest income stratum (OR, 1.23; 95% CI, 1.01-1.49; p = 0.03).
Conclusions:
Children in vulnerable families are at higher risk for injury. The incidence of 12.3% found in this cohort is substantially higher than CDC risk for 5-year-old children, that is, overall 9.3%. This longitudinal cohort has demonstrated a persistently elevated risk of childhood injury, but risk factors for injury have changed with age. As these children reached school age, low household income and male gender were risk factors for injury. This suggests that recognition of gender differences and targeted interventions for caregivers and play environments may be useful.
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