The Role of Community in Pediatric Injury
- 185 Downloads
Cultural variations between communities may impact injury rates, especially among children. We conducted a retrospective study of three communities in Israel using data from the Israel National Trauma Registry (1998–2007). Pediatric injury hospitalization rates in urban communities with varied levels of socio-economic status (low, medium, and high) were compared for all injuries and cause-specific injuries. Age-standardized and age-specific rates were calculated. Age-standardized injury hospitalization rates were lowest for the low socio-economic status (SES) community (299.7, 95% confidence interval [CI] 289.8–309.6) compared to the medium SES (658.2, 95% CI 629.1–687.3) and high SES (443.7, 95% CI 422.2–465.3) communities. Similar rates were observed for injuries from falls, transportation, accidental striking and intentional causes. For example, rate ratios for falls were 149.1 (95% CI 142.0–156.2), 340.8 (95% CI 319.5–362.1) and 245.7 (229.9–261.5) in the low, medium and high SES communities, respectively. Deviations from these overall trends were noted, however, for pedestrian injuries and burns that were relatively higher in the low SES community and injuries from motorized vehicles that were greater among children living in the high SES community. These results suggest that strong social capital is associated with reduced pediatric injury risks regardless of community wealth. However, targeted interventions for reducing injuries in at-risk populations that rely solely on injury rates may omit culturally distinct communities and overlook their uneven burden to the trauma care system.
KeywordsCulture Community Hospitalization Injury Pediatric Socio-economic status
- 1.Peden, M., Oyegbite, K., Ozanne-Smith, J., et al. (2008) Geneva: World report on child injury prevention. World Health Organization.Google Scholar
- 2.World Health Organization (2008). Geneva: Global burden of disease: 2004 update. World Health Organization.Google Scholar
- 9.Kawachi, I., & Berkman, L. S. (2000). Social cohesion, social capital, and health. In I. Kawachi & L. S. Berkman (Eds.), Social epidemiology (pp. 174–190). New York: Oxford University Press.Google Scholar
- 13.Stein, N., Aboraba, M., & Haklai, Z. (2008). Leading causes of death in Israel, 1998–2004. Jerusalem (Israel): Ministry of Health. (Hebrew).Google Scholar
- 14.Israel Police Force. Road Accidents. In: Zionit, Y., Kimchi, M., Ben-Aryeh, A., eds. (2006). Children in Israel. Jerusalem (Israel): National center for children, 200, p 303 (Hebrew).Google Scholar
- 18.Gurovich, N., & Cohen-Kastro, E. (2004). Ultra-Orthodox Jews: Geographic distribution and demographic, social and economic characteristics of the Ultra-Orthodox Jewish population in Israel, 1996–2001. Jerusalem (Israel): Israel Central Bureau of Statistics. (Hebrew).Google Scholar
- 21.Berman, E. (2006). Sect, subsidy, and sacrifice: An economist’s view of Ultra-Orthodox Jews. Quarterly Journal of Economics, 115(3), 905–953.Google Scholar
- 22.Putnam, R. (2000). Bowling alone (pp. 65–79). New York: Simon & Schuster.Google Scholar
- 27.Central Bureau of Statistics. Geographic location of ultra-orthodox communities according to the level of religious homogeneity. Israel: http://www.cbs.gov.il/popisr/haredi_areas_2003.xls Accessed 2 Feb 2010.
- 29.Arian, A., & Shamir, M. (1986). The elections in Israel–1984. New Brunswick: Anson Transaction Books.Google Scholar
- 30.Haklai, Z., Gordon, S., Hillel, S., & Aburaba, M. (2009). Emergency department visits: Demographic characteristics, 2004–2007. Jerusalem (Israel): Ministry of Health. (Hebrew).Google Scholar
- 31.Central bureau of statistics. Local authorities in Israel, 2003. Israel: http://www.cbs.gov.il/www/publications/local_authorities03/local_authorities03_h.htm Accessed 2 Feb 2010.
- 39.Kark, J. D., Shemi, G., Friedlander, Y., Martin, O., Manor, O., & Blondheim, S. H. (1996). Does religious observance promote health? Mortality in secular vs. religious kibbutzim in Israel. American Journal of Health Promotion, 86, 341–346.Google Scholar
- 42.National Council for Child Safety (2004). Children in Israel statistical abstract. Jerusalem (Israel): National Council for Child Safety. 67–70 (Hebrew).Google Scholar