Ryann E Yeo, Michael Branion-Calles, Linda Rothman, Meghan Winters, M Anne Harris
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引用次数: 0
Abstract
Background: Low income has been associated with a higher risk of transportation-related injury however, previous studies have largely relied on area-level income, due to the limited availability of individual-level data.
Methods: To examine the independent and combined roles of individual- and area-level income, this prospective cohort study followed ~ 6,557,000 Canadians from the Canadian Census Health and Environment Cohorts (2006, 2011, 2016), for pedestrian, bicycling, or motor vehicle hospitalizations. Income was measured (1) individually by the low-income cut-off and (2) at the area level using neighbourhood income quintiles. Poisson regression estimated the incidence rate ratios (IRR) and 95% confidence intervals (CI) for transportation-related hospitalizations.
Results: After adjusting for covariates, low-income individuals had higher risks of hospitalizations for pedestrian (IRR = 1.93, 95%CI (1.62, 2.29)), bicycling (IRR = 1.16, 95%CI (1.01, 1.34)) and motor vehicle injuries (IRR = 1.18, 95%CI (1.06, 1.31)). When both individual and neighbourhood income were assessed together we estimated, that those who lived in the lowest income neighbourhoods (compared to the highest) had a higher risk of pedestrian (IRR = 1.80, 95%CI (1.51, 2.14)) and motor vehicle injury (IRR = 1.33, 95%CI (1.22, 1.42)) but lower risk of bicycling injury (IRR = 0.73, 95%CI (0.65, 0.81)).
Conclusions: The interaction between individual and neighbourhood income revealed an increased injury risk for low-income individuals in all neighbourhoods, with large inequities in pedestrian and motor vehicle injury risk persisting even in the highest-income neighbourhoods. These findings demonstrate individual income independently contributes to transportation injury risk, underscoring the importance of considering both individual- and area-level income.
期刊介绍:
Injury Epidemiology is dedicated to advancing the scientific foundation for injury prevention and control through timely publication and dissemination of peer-reviewed research. Injury Epidemiology aims to be the premier venue for communicating epidemiologic studies of unintentional and intentional injuries, including, but not limited to, morbidity and mortality from motor vehicle crashes, drug overdose/poisoning, falls, drowning, fires/burns, iatrogenic injury, suicide, homicide, assaults, and abuse. We welcome investigations designed to understand the magnitude, distribution, determinants, causes, prevention, diagnosis, treatment, prognosis, and outcomes of injuries in specific population groups, geographic regions, and environmental settings (e.g., home, workplace, transport, recreation, sports, and urban/rural). Injury Epidemiology has a special focus on studies generating objective and practical knowledge that can be translated into interventions to reduce injury morbidity and mortality on a population level. Priority consideration will be given to manuscripts that feature contemporary theories and concepts, innovative methods, and novel techniques as applied to injury surveillance, risk assessment, development and implementation of effective interventions, and program and policy evaluation.