Overview

Abstract (English)

Unintentional injuries is an important health concern among children in that it is a major cause of hospitalizations and disability in North America, and is the leading cause of death for children in Canada. This is in light of the fact that a majority of unintentional injuries can be avoided. The current literature looking at predictors of unintentional non-fatal injuries has produced mixed findings. This dissertation examines this important topic using large, nationally representative Canadian and American datasets using a social determinants of health framework. The social determinants of health framework allows one to examine a behaviour or outcome in a more holistic manner, therefore getting closer to uncovering the “root” causes of an outcome, as medical sociologists describe it. Focusing on unintentional injuries occurring in/around the home or in a non-recreation/school setting, this topic was analyzed cross-sectionally, longitudinally, and in a cross-national comparison between Canada and the U.S. Cross-sectionally, the key finding was surprisingly a lack of statistically significant findings. One possible reason for this is the cross-sectional nature of the analysis, in that the influence of variables such as family structure may be more relevant when examined longitudinally i.e. as changes over time. Longitudinally, the key finding was that a change in mixed family structure had a significant and independent association with the occurrence of child injury, even after controlling for factors such as employment status and household income. In the cross-national comparison between Canada and the U.S., there was evidence supporting the notion that a country which has a greater emphasis on policies of economic equality (such as Canada), is less likely to see major differences in the occurrence of adverse child health outcomes between differing socio-economic groups. While unintentional injuries among children has an element of randomness, they are nevertheless still related to social factors including family structure and neighbourhood income, particularly among young children. Due to the importance of injuries to children’s health, it is essential to use the information from studies such as this when creating and putting in practice injury prevent programs and policies.

Abstract (French)

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