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

Author(s)
Su, Jiunn-Yih
He, Vincent Yaofeng
Lithgow, Anna
Guthridge, Steven
Publication Date
2025-11-05
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
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

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