Cradle to grave: how social vulnerability correlates with leading causes of injury-related mortality among children and youth.

Abstract

Background: A higher degree of social vulnerability is associated with greater overall injury risk. However, the overlap of social vulnerability with various injury modalities for mortality has been less explored.

Methods: We conducted a cross-sectional study utilizing Georgia death certificates from 2011 to 2021 in youth aged 0-24 years. Mortality rates from firearms, motor vehicle collisions (MVCs), sudden unexpected infant death (SUID), poisonings, and drownings, with census-level social vulnerability index (SVI) categories were evaluated. A negative binomial regression model was created to identify relationships between injury-related cause of death and SVI.

Results: There were 26,362 total deaths from 2011 to 2021 among children and youth. Of these, 10,643 (40%) were due to the top five injury mechanisms causing fatalities in ages 0-24 years in Georgia over the study period. Children and youth with the least advantage in the socioeconomic and minority and language SVIs had higher rates of injury-related mortality from firearm-related deaths, MVCs, and SUID. However, poisonings were most common in the most advantaged quartiles. Differences in number of firearm-related deaths per population were largest in the minority and language status SVI theme.

Conclusions: Children and youth with greater social vulnerability had higher rates of injury-related mortality, except for those due to poisonings. Tailored resources for injury prevention should be focused on least advantaged communities, while poisoning prevention may be best targeted to children and youth in communities with higher SVI. In addition, the impact of systemic investments in healthcare, education, and neighborhood safety on injury-related mortality across SVIs warrants additional investigation.