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Risk factors for unintentional injury hospitalisation among Aboriginal and non-Aboriginal children in Australia's
Jiunn-Yih Su1, Vincent Yaofeng He1, Anna Lithgow2
1Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
Insights
Unintentional injury hospitalisation (UIH) rates were high in young children. Child maltreatment was linked to UIH, suggesting shared causes and the need for integrated prevention strategies.
Area of Science:
- Pediatric injury prevention
- Public health
- Child maltreatment research
Background:
- Unintentional injuries are a significant cause of hospitalisation in children.
- Investigated incidence and risk factors for unintentional injury hospitalisation (UIH) in young children in Australia's Northern Territory.
Purpose of the Study:
- To determine the incidence and risk factors for unintentional injury hospitalisation (UIH).
- To compare UIH rates between Aboriginal and non-Aboriginal children under 5 years.
- To explore associations between UIH and factors including child maltreatment.
Main Methods:
- Retrospective cohort study utilizing linked perinatal, hospital, school, and child protection data.
- Followed 21,189 children from birth to age 5.
- Modified Poisson regression used for multivariate analysis of risk factors.
Main Results:
- Overall UIH incidence was 25.8 per 1,000 person-years.
- Initial analysis showed higher UIH rates in Aboriginal children, but no difference after adjustment.
- Risk factors included male gender, remote/very remote living, and notifications for abuse or neglect.
Conclusions:
- High UIH incidence rates were observed.
- Evidence suggests an association between UIH and child maltreatment, indicating shared determinants.
- Highlights the need for clinician awareness of this overlap and cross-agency collaboration for prevention.
Background:
Unintentional injuries are a leading cause of hospitalisation for children. This study investigated the incidence and associated risk factors for unintentional injury hospitalisation (UIH) among Aboriginal and non-Aboriginal children aged under 5 years in Australia's Northern Territory.
Methods:
This was a retrospective cohort study using linked data from a perinatal register, hospital admissions, school enrolment and child protection services. The outcome variable was a first UIH. Potential risk factors included gender, pregnancy and birth outcomes, maternal education level, child protection service contact and geographic remoteness. Modified Poisson regression was used for multivariate modelling.
Results:
A cohort of 21,189 children (54.0% Aboriginal) born between 2000 and 2010 were followed to the age of 5 years. The overall incidence of first UIH was 25.8 per 1,000 person-years, which was 28.6% higher among Aboriginal than non-Aboriginal children (28.8 and 22.4 per 1000 person-years, respectively). Risk factors identified in the full model included: being male (incidence rate ratio (IRR) 1.26, 95%CI: 1.17-1.36); living in a remote (IRR 1.26, 95%CI: 1.14-1.40) or very remote area (IRR 1.44, 95%CI: 1.29-1.59); having a notification or substantiated notification for abuse (IRR 1.42, 95%CI: 1.27-1.58 and IRR 1.60, 95%CI: 1.41-1.82, respectively); or neglect (IRR 1.32, 95%CI: 1.17-1.48 and IRR 1.28, 95%CI: 1.11-1.47, respectively). After adjustment, there was no difference in UIH rates between Aboriginal and non-Aboriginal children. In both stratified models, being male, living in remote or very remote areas and having a notification or substantiated notification for child maltreatment were identified as risk factors.
Conclusions:
Our study found high UIH incidence rates and evidence for an association between UIH and child maltreatment. This suggests child maltreatment and UIH have shared determinants and points to the need for clinicians to be aware of the overlap between these conditions and the importance of cross-agency collaboration in prevention and management.
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