Understanding inequities in Canadian children’s traffic injuries using national census linked to health records
Research leads Dr. Anne Harris, Dr. Linda Rothman (also affiliated with the University of Toronto), and research assistant Ryann Yeo from Toronto Metropolitan University, provide an update on their study supported by the Edwin S.H. Leong Centre for Healthy Children.
Transportation crashes are a leading cause of death and injury to children in Canada, and risk is not equitable in the population. Injuries while children are bicycling and walking can be particularly dangerous, and prior work has found that these injuries often occur more frequently in lower income neighbourhoods. Many studies of traffic injury rely on police reports, which can miss some unreported injuries, and on information about neighbourhoods where injuries occur, rather than on characteristics of households or individual children who are injured. Epidemiological studies of large linked databases can address these information gaps.
This project uses data from the Canadian Census, which Statistics Canada has linked to records of hospital visits and admissions provided by the Canadian Institute for Health Information (CIHI) and records of deaths from Canadian national mortality data. This unique database is called the Canadian Census Health and Environment Cohorts (CanCHECs). Beginning with the 2006 census, all household members covered by the long form census, including children, were included in the linkage. The team used this data to isolate a subcohort of children known as CanCHECKids. The data was accessed via the Research Data Centre Network, which partners Universities and Statistics Canada to ensure research access to critical national databases. To study relationships between sociodemographic factors and traffic injury, the team examined characteristics of children within CanCHECKids, along with same household adults, including household income, ethnicity, immigration status, age, gender, single parental status, parental education level, parental employment, rurality, and modes of transportation used for household commuters. Research findings will be presented at upcoming conferences (Canadian Public Health Association, Canadian Association of Road Safety Professionals) and at a future Edwin S.H. Leong Centre for Healthy Children seminar event.
The project has formed an invaluable training experience for research team member Ryann Yeo, who first joined the team as a Masters of Public Health practicum and has worked as a research assistant following her graduation. “Working with the CanCHECs dataset to explore childhood health inequities has been a great learning experience, helping me grow as an epidemiologist. The dataset is unique in both its size and the amount of information it provides, allowing us to explore a wide range of risk factors that wouldn't have been possible with other data sources.”
A second arm of the project examines features of the neighbourhoods in which injured children in CanCHECKids live, compared to a sample of CanCHECKids who have not experienced injury (a nested case-control study). Taken together, these projects form unique ways to understand traffic injury in Canadian children and underscore that prevention efforts will alleviate both injury and inequities in health in children.