Background Research has consistently shown that low socioeconomic status (SES) is associated with an increased risk of child injury mortality (CIM). However, other social factors may influence CIM as well. In Israel, there are two additional demographic factors: nationality (Jews vs Arabs) and the level of religious affiliation among Jews (Ultra Orthodox vs Non-Ultra Orthodox) that might affect the relationship between SES and CIM.

Purpose To examine the relationship between these three demographic factors and CIM.

Methods Analysis of census data (2003–2009) of CIM in 116 municipalities; covering over 90% of the children in Israel. The municipalities are divided into three SES levels, three nationalities (Jews, Arabs and Mixed), and two levels of religious affiliation among Jews (Ultra Orthodox and Non-Ultra Orthodox).

Results CIM rates in municipalities were higher for low SES than for high SES (OR=2, 95%, CI 1.6 to 2.5), and higher for Arabs than for Jews (OR=2.6, 95% CI 2.2 to 3.0). However, among the Jewish municipalities there is no clear relation between SES level and CIM rates; CIM rates are lower for Ultra Orthodox than for Non-Ultra Orthodox municipalities (OR=0.3, 95% CI 0.1 to 0.6), although the Ultra Orthodox municipalities include 90% of the Jewish children in the low SES.

Significance Although both the Arab and the Ultra Orthodox populations are characterised by low SES and high birth rates, we found that CIM rates are much higher for Arab municipalities than for Jewish Ultra Orthodox municipalities. Therefore, nationality and religious affiliation (among Jews) are as important as SES in predicting CIM.