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Inequality in child accident deaths is increasing

Social class inequalities in childhood deaths due to injury have increased since 1979, according to new research evidence published in the British Medical Journal.

Epidemiologists from the Institute of Child Health in London say that death rates from injury and poisoning have fallen for children in all social groups—but the decline for children of middle class parents has been much greater than that for children of working class parents.

At the start of the 1980s, the injury death rate for children in social class V (unskilled manual workers) was three and a half times that of children in social class I (professional workers). By the end of the decade, the ratio had increased to five times.

The researchers point out that the increasing inequality raises the possibility that the Health of the Nationtarget for reducing childhood accidental death will be met for children in non-manual social classes, but not for those in manual social classes.

They believe that the most likely explanation for the increasing health inequalities in children, as in adults, is increasing inequality of exposure to ‘health damaging physical and social environments’, as a result of widening income inequality. For example, the risk of death in a car accident is higher for occupants of small cars rather than those of larger cars. Newer cars are alos likely to be fitted with more safety features, but will be beyond the means of most people on low incomes. Motor vehicle accidents account for almost half of all child injury deaths.

Similarly, fire risk, for which a steep social class gradient exists, is greatest for people living in the poorest council housing and in temporary accommodation.

Roberts I, Power P. BMJ 1996;313:784-6.