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Canadian Child Safety Report Card: a comparison of injury prevention practices across provinces
  1. Liraz Fridman1,
  2. Jessica L Fraser-Thomas1,
  3. Ian Pike2,
  4. Alison K Macpherson1
  1. 1 School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
  2. 2 Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
  1. Correspondence to Dr Liraz Fridman, Department of Kinesiology and Health Science, Bethune College, Toronto, ON M3J 1P3, Canada; liraz{at}


Background Injury prevention report cards that raise awareness about the preventability of childhood injuries have been published by the European Child Safety Alliance and the WHO. These report cards highlight the variance in injury prevention practices around the world. Policymakers and stakeholders have identified research evidence as an important enabler to the enactment of injury legislation. In Canada, there is currently no childhood injury report card that ranks provinces on injury rates or evidence-based prevention policies.

Methods Three key measures, with five metrics, were used to compare provinces on childhood injury prevention rates and strategies, including morbidity, mortality and policy indicators over time (2006–2012). Nine provinces were ranked on five metrics: (1) population-based hospitalisation rate/100 000; (2) per cent change in hospitalisation rate/100 000; (3) population-based mortality rate/100 000; (4) per cent change in mortality rate/100 000; (5) evidence-based policy assessment.

Results Of the nine provinces analysed, British Columbia ranked highest in Canada and Saskatchewan lowest. British Columbia had a morbidity and mortality rate that was close to the Canadian average and decreased over the study period. British Columbia also had a number of injury prevention policies and legislation in place that followed best practice guidelines. Saskatchewan had a higher rate of injury hospitalisation and death; however, Saskatchewan’s rate decreased over time. Saskatchewan had a number of prevention policies in place but had not enacted bicycle helmet legislation.

Conclusions Future preventative efforts should focus on harmonising policies across all provinces in Canada that reflect evidence-based best practices.

  • epidemiology
  • childhood injury
  • report card
  • Canada

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  • Contributors LF, AKM and IP were responsible for the conceptualisation of the report card. LF was responsible for data analysis and reporting of results. IP and JLFT provided feedback and editing of the manuscript.

  • Funding AM is supported by CIHR - Chairs in Reproductive and Child Health Services and Policy Research.

  • Competing interests None declared.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Ethics approval York University

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional unpublished data from the study are available. The report cards will be published separately to this manuscript on the Canadian Atlas of Child and Youth Injury Prevention:

  • Correction notice This article has been corrected since it was published Online First. ’Unintentional injury' has been replaced by the more appropriate statement ’all-cause injuries'. ICD-10 codes (page 1) have also been updated.