Su, Jiunn-Yih; He, Vincent Yaofeng; Lithgow, Anna; Guthridge, Steven

Author(s)

Su, Jiunn-Yih

He, Vincent Yaofeng

Lithgow, Anna

Guthridge, Steven

Publication Date

2024-11-05

Abstract

Unintentional injuries are a leading cause of hospitalisation for children. This study investigated the incidence and associated risk factors for unintentional injury hospitalisation (UIH) among Aboriginal and non-Aboriginal children aged under 5 years in Australia's Northern Territory.This was a retrospective cohort study using linked data from a perinatal register, hospital admissions, school enrolment and child protection services. The outcome variable was a first UIH. Potential risk factors included gender, pregnancy and birth outcomes, maternal education level, child protection service contact and geographic remoteness. Modified Poisson regression was used for multivariate modelling.A cohort of 21,189 children (54.0% Aboriginal) born between 2000 and 2010 were followed to the age of 5 years. The overall incidence of first UIH was 25.8 per 1,000 person-years, which was 28.6% higher among Aboriginal than non-Aboriginal children (28.8 and 22.4 per 1000 person-years, respectively). Risk factors identified in the full model included: being male (incidence rate ratio (IRR) 1.26, 95%CI: 1.17-1.36); living in a remote (IRR 1.26, 95%CI: 1.14-1.40) or very remote area (IRR 1.44, 95%CI: 1.29-1.59); having a notification or substantiated notification for abuse (IRR 1.42, 95%CI: 1.27-1.58 and IRR 1.60, 95%CI: 1.41-1.82, respectively); or neglect (IRR 1.32, 95%CI: 1.17-1.48 and IRR 1.28, 95%CI: 1.11-1.47, respectively). After adjustment, there was no difference in UIH rates between Aboriginal and non-Aboriginal children. In both stratified models, being male, living in remote or very remote areas and having a notification or substantiated notification for child maltreatment were identified as risk factors.Our study found high UIH incidence rates and evidence for an association between UIH and child maltreatment. This suggests child maltreatment and UIH have shared determinants and points to the need for clinicians to be aware of the overlap between these conditions and the importance of cross-agency collaboration in prevention and management.

Affiliation

Menzies School of Health Research, Charles Darwin University, Darwin, Australia.

Department of Paediatrics, Royal Darwin Hospital, Darwin, Australia.

Menzies School of Health Research, Charles Darwin University, Darwin, Australia.

Citation

PLoS One . 2024 Nov 5;19(11):e0311586. doi: 10.1371/journal.pone.0311586. eCollection 2024.

ISSN

1932-6203

OrcId

0000-0003-1345-8013

Pubmed ID

https://pubmed.ncbi.nlm.nih.gov/39499709/?otool=iaurydwlib

Link

https://hdl.handle.net/10137/13791

Subject

MESH subject

Child, Preschool

Female

Humans

Infant

Infant, Newborn

Male

Accidental Injuries

Hospitalization

Incidence

Information Storage and Retrieval

Northern Territory

Retrospective Studies

Risk Factors

Australian Aboriginal and Torres Strait Islander Peoples

Title

Risk factors for unintentional injury hospitalisation among Aboriginal and non-Aboriginal children in Australia's Northern Territory: A data linkage study.

Type of document

Journal Article

Entity Type

Publication

Author(s)	Su, Jiunn-Yih He, Vincent Yaofeng Lithgow, Anna Guthridge, Steven
Publication Date	2024-11-05
Abstract	Unintentional injuries are a leading cause of hospitalisation for children. This study investigated the incidence and associated risk factors for unintentional injury hospitalisation (UIH) among Aboriginal and non-Aboriginal children aged under 5 years in Australia's Northern Territory.This was a retrospective cohort study using linked data from a perinatal register, hospital admissions, school enrolment and child protection services. The outcome variable was a first UIH. Potential risk factors included gender, pregnancy and birth outcomes, maternal education level, child protection service contact and geographic remoteness. Modified Poisson regression was used for multivariate modelling.A cohort of 21,189 children (54.0% Aboriginal) born between 2000 and 2010 were followed to the age of 5 years. The overall incidence of first UIH was 25.8 per 1,000 person-years, which was 28.6% higher among Aboriginal than non-Aboriginal children (28.8 and 22.4 per 1000 person-years, respectively). Risk factors identified in the full model included: being male (incidence rate ratio (IRR) 1.26, 95%CI: 1.17-1.36); living in a remote (IRR 1.26, 95%CI: 1.14-1.40) or very remote area (IRR 1.44, 95%CI: 1.29-1.59); having a notification or substantiated notification for abuse (IRR 1.42, 95%CI: 1.27-1.58 and IRR 1.60, 95%CI: 1.41-1.82, respectively); or neglect (IRR 1.32, 95%CI: 1.17-1.48 and IRR 1.28, 95%CI: 1.11-1.47, respectively). After adjustment, there was no difference in UIH rates between Aboriginal and non-Aboriginal children. In both stratified models, being male, living in remote or very remote areas and having a notification or substantiated notification for child maltreatment were identified as risk factors.Our study found high UIH incidence rates and evidence for an association between UIH and child maltreatment. This suggests child maltreatment and UIH have shared determinants and points to the need for clinicians to be aware of the overlap between these conditions and the importance of cross-agency collaboration in prevention and management.
Affiliation	Menzies School of Health Research, Charles Darwin University, Darwin, Australia. Menzies School of Health Research, Charles Darwin University, Darwin, Australia. Department of Paediatrics, Royal Darwin Hospital, Darwin, Australia. Menzies School of Health Research, Charles Darwin University, Darwin, Australia.
Citation	PLoS One . 2024 Nov 5;19(11):e0311586. doi: 10.1371/journal.pone.0311586. eCollection 2024.
ISSN	1932-6203
OrcId	0000-0003-1345-8013
Pubmed ID	https://pubmed.ncbi.nlm.nih.gov/39499709/?otool=iaurydwlib
Link	https://hdl.handle.net/10137/13791
Subject
MESH subject	Child, Preschool Female Humans Infant Infant, Newborn Male Accidental Injuries Hospitalization Incidence Information Storage and Retrieval Northern Territory Retrospective Studies Risk Factors Australian Aboriginal and Torres Strait Islander Peoples
Title	Risk factors for unintentional injury hospitalisation among Aboriginal and non-Aboriginal children in Australia's Northern Territory: A data linkage study.
Type of document	Journal Article
Entity Type	Publication

Risk factors for unintentional injury hospitalisation among Aboriginal and non-Aboriginal children in Australia's Northern Territory: A data linkage study.

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