Spatial Epidemiology of Child and Youth Injury

Injury is one of the leading causes of death amongst Canadian children. Every year, it is estimated that approximately 25000 children will be hospitalized because of unintentional injuries – of these 25000, nearly 400 are likely to die. However, not all children are equally at risk. Studies have shown that children from socio-economically deprived families are at higher risk of morbidity and mortality as a result of injuries. In fact, despite a steady decrease in total rates of injury within the Western world, the difference in rates of pediatric injury between rich and poor has actually broadened in recent decades. In addition, injury has been shown to have a geographical gradient, whereby populations residing in rural areas experience worse outcomes compared to urban dwellers. This is primarily attributable to the reduced access to pediatric trauma centres amongst rural populations, as rapid access to pediatric trauma centres have been shown to produce superior outcomes with severely injured patients. This dissertation encompasses an analysis of pediatric trauma centre access and socioeconomic status within specific regions of Canada and Israel. Its two principal objectives involve: 1) an analysis of the geographical distribution of major traumas within the child and youth population; and 2) an assessment of the effectiveness of pediatric trauma systems in dealing with these injuries within both of the countries under observation. On a more granular level, the project aims to describe the hotspots for child and youth injury, to identify disadvantaged populations and high risk injury mechanisms and patterns, and to explore the barriers that impede access to appropriate care in both of the study regions. It is also intended to improve the methodology available to researchers in dealing with locational error within injury data. The results will assist decision makers in prioritizing the delivery of health care services and will help direct scarce prevention-related public health resources to high risk populations.