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. 2016 May;106(5):899-905.
doi: 10.2105/AJPH.2015.303022. Epub 2016 Feb 18.

Inequalities in Hospitalized Unintentional Injury Between Aboriginal and Non-Aboriginal Children in New South Wales, Australia

Holger Möller  1 , Kathleen Falster  1 , Rebecca Ivers  1 , Michael Falster  1 , Deborah Randall  1 , Kathleen Clapham  1 , Louisa Jorm  1
Affiliations

Inequalities in Hospitalized Unintentional Injury Between Aboriginal and Non-Aboriginal Children in New South Wales, Australia

Holger Möller et al. Am J Public Health. 2016 May.

Abstract

Objectives: To quantify inequalities in rates of unintentional injury-related hospitalizations between Australian Aboriginal and non-Aboriginal children.

Methods: We used linked hospital and mortality data to construct a retrospective whole-of-population birth cohort including 1,124,717 children born in the state of New South Wales, Australia, between July 1, 2000 and December 31, 2012. We adjusted hazard ratios (HRs) of first injury hospitalization for geographic clustering and individual- and area-level factors.

Results: Aboriginal children were 1.6 times more likely than were non-Aboriginal children to be hospitalized for an unintentional injury. The largest inequalities were for poisoning (HR = 2.7; 95% CI = 2.4, 3.0) and injuries stemming from exposure to fire, flames, heat, and hot substances (HR = 2.4; 95% CI = 2.1, 2.7). Adjustment reduced the inequality for all unintentional injury overall (HR = 1.4; 95% CI = 1.3, 1.4) and within leading injury mechanisms.

Conclusions: Australian Aboriginal children suffer a disproportionately high burden of unintentional injury.

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Figures

FIGURE 1—
FIGURE 1—
Probability of Hospitalization for Unintentional Injury by Age in a Cohort of Aboriginal and Non-Aboriginal Children: New South Wales, Australia, 2000–2014
FIGURE 2—
FIGURE 2—
Adjusted Hazard Ratios for Hospitalization for Unintentional Injury for Interaction Terms Aboriginality × Area Socioeconomic Status and Aboriginality × Remoteness: New South Wales, Australia, 2000–2014 Note. Adjusted hazard ratios accounted for clustering within statistical local area and other covariates (model 4). Error bars represent 95% confidence intervals. We added interactions separately to the model. The referent groups were non-Aboriginal children living in most disadvantaged areas and non-Aboriginal children living in major cities. SES is from the Index of Relative Socio-Economic Advantage and Disadvantage. We obtained remoteness from the Accessibility/Remoteness Index of Australia.
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References

    1. Australian Institute of Health and Welfare. The Health and Welfare of Australia’s Aboriginal and Torres Strait Islander People, an Overview. Canberra, Australia: 2011.
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    1. Australian Institute of Health and Welfare. A Picture of Australia’s Children 2012. Canberra, Australia: 2012.

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