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Recent trends in child and youth emergency department visits because of pedestrian motor vehicle collisions by socioeconomic status in Ontario, Canada
  1. Linda Rothman1,
  2. Colin Macarthur2,
  3. Andrew Wilton3,
  4. Andrew William Howard4,
  5. Alison K Macpherson5
  1. 1 CHES, The Hospital for Sick Children, Toronto, Ontario, Canada
  2. 2 Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
  3. 3 Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
  4. 4 Orthopaedic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
  5. 5 School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
  1. Correspondence to Linda Rothman, CHES, Hospital for Sick Childrenx, Toronto ON M5G 1X8, Canada; linda.rothman{at}sickkids.ca

Abstract

Background Children in lower-income households have higher injury rates. Trends in emergency department (ED) visits by children 0–19 years because of pedestrian motor vehicle collisions (PMVCs) in Ontario, Canada (2008–2015) by socioeconomic status were examined.

Methods PMVC ED data were obtained from the Institute for Clinical Evaluative Sciences for children age 0–19 years over the period 2008–2015. Age-adjusted rates were calculated using Ontario census data. Household income quintiles were determined from the Registered Persons Database. Poisson regression was used to model ED visit rates by year, age and income quintile.

Results The frequency of child PMVC ED visits in Ontario decreased from 1562 in 2008 to 1281 in 2015. Age-adjusted rates were unchanged over time (IRR 1.00, 95% CI 0.99 to 1.00); however, rate disparities by income status persisted with an IRR of 0.52 (0.50 to 0.55) comparing the highest with the lowest income level.

Conclusions Exposure to traffic may play a role in rate disparities by income status in child PMVC; however, less safe traffic environments in lower income areas may also be strong contributors. These findings highlight the potential impact of roadway safety modifications in lower income areas to mitigate disparities in injury rates by socioeconomic status.

  • children
  • pedestrian
  • motor vehicle collisions
  • socioeconomic
  • injury

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Footnotes

  • Contributors LR was responsible for the conceptual framework and design, analysis and interpretation, and writing and editing of the manuscript. CM, AW and AKM contributed to the conceptual framework and design, analysis and interpretation, writing and critical editing of the manuscript. AWH contributed to the conceptual framework and design, and critical editing of the manuscript

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

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