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Abstract
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STUDY OBJECTIVE: To study municipal variations in
children's injury risk and to assess the impact of safety promotion
measures in general municipal, preschool, school, and leisure activity settings,
on injury outcome. DESIGN: A cohort study based on individual data on
children's consumption of hospital care as a result of injury, the age and
sex of each child, and socioeconomic data on each child's mother. Municipal
characteristics-that is, population density and municipal safety measures-were
also used. Connections between individual and community level determinants were
analysed with multilevel logistic regression. SETTING: Twenty five
municipalities in Stockholm County in Sweden were studied. PARTICIPANTS:
Children between 1 and 15 years old in 25 municipalities in Stockholm County,
identified in the Total Population Register in Sweden. The study base included 1
055 179 person years. MAIN RESULTS: Municipality injury rates varied between
3.84-7.69 per 1000 person years among 1-6 year olds and, between 0.86-6.18 among
7-15 year olds. Implementation of multiple safety measures in a municipality had
a significant effect on the risk of injury for preschool children. In
municipalities that implemented few safety measures, the risk of injury was 33%
higher than in municipalities that implemented many. A similar effect, though
insignificant, was observed in the school aged children. CONCLUSIONS: This study
shows that how municipalities organise their safety activities affect injury
rates. Sweden has a comparatively low injury rate and thus, in a European
perspective, there is an obvious potential for municipal safety
efforts. |