Varying gender pattern of childhood injury mortality over time in Scotland

Objective: This article explores gender in relation to Scottish child injury mortality over time. Design: Injury mortality data for children aged 0-14 years in Scotland were obtained from the General Register Office for Scotland. The study period was 1982-2006 inclusive. Data were analysed in terms of age, gender, year of death and cause of death. Age-adjusted injury mortality rates, male: female (m:f) ratios and temporal trends were calculated. Setting: Scotland, UK. Subjects: Children, aged 0-14 years, resident in Scotland, who died from injury during the study period. Results: There was an overall significant male excess (m:f ratio 1.70). Boys were significantly more likely to die from injuries in all age groups except infancy (m:f ratio 1.20, 1.32, 2.09, 2.09 in age groups <1, 1-4, 5-9 and 10-14 years). For childhood as a whole, the most gender-related fatal injury causes were poisoning (m:f ratio 3.21), falls (m:f ratio 2.75), suicide (m:f ratio 2.19), drowning and suffocation (m:f ratio 2.09), pedestrian (m:f ratio 1.72) and road traffic injuries (m:f ratio 1.65). The only cause that did not show a significant m: f ratio was fire. The male excess declined markedly over time. Conclusion: The gender pattern of child injury mortality in Scotland is highly variable and changing over time to the point where the previous male excess has almost disappeared in some age and cause categories. The overall male excess in child injury mortality has, however, remained consistent over time although the trend is downwards and converging. These findings are largely unexplained.