Socio-economic inequalities in injury incidence in the Netherlands
Background: Interventions to reduce socio-economic inequalities in injury incidence should be tailored to specific priority areas that may be identified by descriptive studies. We aimed to provide an overview of existing socio-economic inequalities in injury incidence in the Netherlands and to assess the potential influence of methodological choices on the relationships found. Methods: Self-reported medically treated injuries (all injuries versus fractures) were derived from a survey among a random sample of 59 063 persons. Injuries resulting in hospital admissions (all injuries versus fractures) were derived from a prospective cohort study of 18 810 participants, linked to the National Hospital Discharge Register for a follow-up period of 7 years. Logistic regression was used to calculate the odds ratios of self-reported medically treated injuries and fractures by level of education, occupation and income, and of hospital-admitted injuries by level of education and occupation. Results: Socio-economic inequalities in injury incidence in the Netherlands were dependent on the indicator of non-fatal injury incidence, indicator of socio-economic status (SES) and studied cause of injury. In the majority of specific relations analyzed, injury risks were not or only moderately elevated in lower SES-classes. Analyses focusing on injury with higher severity levels (admitted injuries and/or admitted fractures) revealed the steepest SES gradient with odds ratios of injury of 1.5 or more of the lowest socio-economic (educational) groups compared to persons with higher SES (education). In hospital admitted traffic injuries, we found the most striking difference with a threefold higher risk in the lowest educational groups. Conclusion: Future descriptive research into socio-economic differences in injury incidence should include all three core indicators of SES and separate analyses on the more severe injuries should be conducted.
van Beeck, E.F, van Lenthe, F.J, Toet, H, Hertog den, P, & van Baar, M.E. (2009). Socio-economic inequalities in injury incidence in the Netherlands. Italian Journal of Public Health, 3(2), 51–56. Retrieved from http://hdl.handle.net/1765/16477