Socioeconomic status and non-fatal injuries among Canadian adolescents: variations across SES and injury measures

Background: While research to date has consistently demonstrated that socioeconomic status (SES) is inversely associated with injury mortality in both children and adults, findings have been less consistent for non-fatal injuries. The literature addressing SES and injury morbidity among adolescents has been particularly inconclusive. To explore potential explanations for these discrepant research findings, this study uniquely compared the relationship across different measures of SES and different causes of injury ( recreation versus non-recreation injuries) within a sample of Canadian adolescents. Methods: The sample included adolescent participants ( aged 12 to 19 years) in the Canadian 1996-1997 cross-sectional National Population Health Survey (n = 6967). Five SES measures ( household income, two neighbourhood-level proxy measures, two parental indicators) were examined in relation to three injury outcomes ( total, recreation, and non-recreation injuries) using multivariable logistic regression. Results: Among males, a clear relationship with injury was observed only for a parental SES index, which was positively associated with total and recreation injuries ( odds ratios for the highest versus lowest SES category of 1.9 for total and 2.5 for recreation injuries). Among females, there was some evidence of a positive relationship between SES and injuries, particularly for a neighbourhood-level education measure with total and recreation injuries ( odds ratios of 1.7 for total and 2.0 for recreation injuries). Conclusion: The results suggest that differences related to the measures of SES chosen and the causes of injury under study may both contribute to discrepancies in past research on SES and non-fatal injuries among adolescents. To clarify the potential SES-injury relationship among youth, the findings emphasize a need for a greater understanding of the meaning and relevance of different SES measures for adolescents, and for an exploration of the pathways through which SES may be related to injury risk.