Neighborhood social composition and injury risks among pre-adolescent and adolescent boys and girls. A study in Stockholm metropolitan.

The study investigates the extent to which social and socioeconomic characteristics of a population within a particular living area influence injury risks among young people. The study group comprised pre-adolescent and adolescent boys and girls aged 10-19 living in the Stockholm metropolitan area in Sweden over the three-year period 2000--2002 (about 185,000 subjects each year). Area comparisons were made at parish level (96 parishes) based on three compositional indexes derived from a factor analysis of sixteen population attributes. Thereafter, each factor was transformed into an additive index and divided into three levels. Diagnosis-specific injury risks were then measured by index, considering injury causes with documented social differences (five for boys and three for girls). Injuries resulting in at least one night of hospitalization during the period 2000--2002 were considered. Three main dimensions with regard to the social fabric of the Stockholm metropolitan area were identified: socioeconomic precariousness and ethnic concentration (Factor 1), educational and financial assets (Factor 2), and concentration of well-off citizens of Nordic origin (Factor 3). Lower levels of socioeconomic precariousness and ethnic concentration showed a protective effect on boys in the cases of traffic and sports-related injuries, but an aggravating one in the cases of falls on the same level and violence-related injuries. Level of educational and financial assets did not impact on falls on the same level among boys, but increased the risk of such injuries among girls. Increased risks of traffic-related injuries among boys and of falls on the same level among both boys and girls were found in areas with lower concentrations of well-off citizens of Nordic origin. It is concluded that social and socioeconomic composition of the population in a living area impacts on injury risks of various kinds in a rather specific manner--in magnitude and in kind. The mechanisms via which contextual aspects operate during youth are likely to vary according to type (cause) of injury and gender.