Socioeconomic status and risk of car crash injury, independent of place of residence and driving exposure: results from the DRIVE Study
Socioeconomic status and risk of car crash injury, independent of place of residence and driving exposure: results from the DRIVE Study
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DOI：
10.1136/jech.2009.091496
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发表时间：
2010-11-01
影响因子：
6.3
通讯作者：
Norton, R.
中科院分区：
文献类型：
--
作者：
Chen, H. Y.;Ivers, R. Q.;Norton, R.
之前的研究发现，低社会经济地位（SES）的年轻司机撞车风险增加，但未能调整驾驶暴露和农村居住等因素。本研究的目的是检查SES对碰撞风险的独立影响，调整这些因素，并检查碰撞后伤害严重程度与SES之间的关系。方法：作为DRIVE研究的一部分，从澳大利亚新南威尔士州的20822名17-24岁的新驾照司机中收集碰撞危险因素信息，并将其与住院数据前瞻性地联系起来。根据澳大利亚2001年各地区社会经济指数，将社会经济状况分为高、中、低三个等级。泊松回归通过SES对坠机相关住院的风险进行建模，并对混杂因素进行调整。采用SES对损伤严重程度的两项指标——治疗急迫性和住院时间进行检测。多变量分析结果显示，与来自高经济地位地区的司机相比，来自低经济地位地区的司机因车祸住院的相对风险（RR 1.8, 95% CI 1.1至3.1）更高。当调整混杂因素包括驾驶暴露和乡村性时，这种增加的风险仍然存在（RR 1.9, 95% CI 1.1至3.2）。损伤严重程度与SES之间无显著关联。结论低社会经济地位地区年轻驾驶员因交通事故住院的较高风险与驾驶暴露和城乡差异无关。这一发现可能有助于改善和更好地针对低社会经济地位青少年的干预措施。
Background Previous studies that found increased crash risks for young drivers of low socioeconomic status (SES) have failed to adjust for factors such as driving exposure and rural residence. This aim of this study is to examine the independent effect of SES on crash risk, adjusting for such factors, and to examine the relationship between injury severity following a crash and SES.Methods Information on risk factors for crash collected from 20 822 newly licenced drivers aged 17-24 years in New South Wales, Australia, as part of the DRIVE Study was prospectively linked to hospitalisation data. SES was classified as high, moderate or low based on the Australia 2001 Socio-Economic Index for Areas. Poisson regression was used to model risk of crash-related hospitalisation by SES, adjusting for confounders. Two measures of injury severity-urgency of treatment and length of hospital stay-were examined by SES.Results Results of multivariable analysis showed that drivers from low SES areas had increased relative risk (RR 1.8, 95% CI 1.1 to 3.1) of crash-related hospitalisation compared to drivers from high SES areas. This increased risk remained when adjusting for confounders including driving exposure and rurality (RR 1.9, 95% CI 1.1 to 3.2). No significant association was found between injury severity and SES.Conclusion The higher risk of crash-related hospitalisation for young drivers from low SES areas is independent of driving exposure and rural-urban differences. This finding may help improve and better target interventions for youth of low SES.