Disparities in fatal and non-fatal injuries between Irish travellers and the Irish general population are similar to those of other indigenous minorities: a cross-sectional population-based comparative study

Abstract

Objectives: To assess recent disparities in fatal and non-fatal injury between travellers and the general population in Ireland.

Design: A cross-sectional population-based comparative study.

Setting: Republic of Ireland.

Participants: Population census and retrospective mortality data were collected from 7042 traveller families, travellers being those identified by themselves and others as members of the traveller community. Retrospective injury incidence was estimated from a survey of a random sample of travellers in private households, aged 15 years or over (702 men and 961 women). Comparable general population data were obtained from official statistical reports, while retrospective incidence was estimated from the Survey of Lifestyle, Attitude and Nutrition 2002, a random sample of 5992 adults in private households aged 18 years or over.

Outcome measures: Potential Years of Life Lost (PYLL), Standardised Mortality Ratios (SMR), Standardised Incidence Ratios (SIR) and Case Fatality Ratios (CFR).

Results: Injury accounted for 36% of PYLL among travellers, compared with 13% in the general population. travellers were more likely to die of unintentional injury than the general population (SMR=454 (95% CI 279 to 690) in men and 460 (95% CI 177 to 905) in women), with a similar pattern for intentional injury (SMR=637 (95% CI 367 to 993) in men and 464 (95% CI 107 to 1204 in women). They had a lower incidence of unintentional injury but those aged 65 years or over were about twice as likely to report an injury. Travellers had a higher incidence of intentional injuries (SIR=181 (95% CI 116 to 269) in men and 268 (95% CI 187 to 373) in women). Injury CFR were consistently higher among travellers.

Conclusions: Irish travellers continue to bear a disproportionate burden of injury, which calls for scaling up injury prevention efforts in this group. Prevention and further research should focus on suicide, alcohol misuse and elderly injury among Irish travellers.

Figure 1

Distribution of fatal and non-fatal injuries by intent for Irish travellers and the general population, Republic of Ireland. The figure displays vertical bar charts of the distribution of fatal and non-fatal injuries by intent among Irish travellers and the general population. The x-axis represents the categories of Irish travellers with 34 injury deaths in All-Ireland traveller Health Study (AITHS) mortality study and 193 non-fatal injuries among those aged 15 years or over in AITHS adult health status survey sample in 2008, and the general population with 2277 injury deaths in 2008 and 908 non-fatal injuries among those aged 18 years or over in SLAN 2002 sample. The y-axis represents the percentage of unintentional, intentional and unspecified intent injuries out of the total for each category. Unintentional deaths represented a larger proportion of injury deaths in travellers and the general population, but the proportion of intentional injuries was higher in travellers than the general population, with a similar pattern for non-fatal injury.