Background Injury remains the leading cause of childhood mortality and disability worldwide. This burden is greatest in communities of lower socioeconomic status (SES), especially in low and middle-income countries. Little appears known about injury outcomes in children in the context of equity.
Objective To understand the burden of functional and health related quality of life outcomes in children after injury in relation to equity.
Methods Key terms for intentional and unintentional injury were searched over 6 databases. Inclusion criteria focused records on injury research,<16 years of age and observational studies with ≥3 outcome time points measured. PRISMA-E 2012 guidelines were followed, where a narrative base synthesis was applied to describe outcomes in the context of injury. PROGRESS-Plus and Equity Lens tools were used to examine the focus on equity in studies and outcomes, and the RTI Item Bank assessed the level of bias in articles.
Findings A total of 3931 records were returned where screening resulted in 24 articles progressing to review. Most studies (88%) were conducted in high income countries, with a focus on traumatic brain injury (62.5%) and functional outcomes (56%). Preinjury functioning and Health Related Quality of Life (HRQoL) measures were key indicators of postinjury outcomes. Longer hospitalization was linked to poorer functional and HRQoL outcomes. The majority (80%) of studies had not considered equity factors, limited studies reported on the connection of low SES and poor outcomes.
Conclusion Injury severity, longer hospitalisation and lower SES have a negative impact on injury recovery, reducing functional and HRQoL outcomes in children. Currently most outcome based injury research is conducted with a ‘privileged research lens’ excluding notions of health inequities, creating further population disparities and disadvantage.
Policy implications Injury research agendas need reform, to focus research on improving health inequities and provide health gains for all children.
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