8. Injury deaths
Why are child injury death rates important?
Injury is a leading cause of death for children aged 0–14 in Australia, and is also a major cause of hospitalisation (AIHW: Pointer 2014).
Children are particularly vulnerable to certain types of injuries, depending on their age which has often been considered to reflect development (Flavin et al. 2006; MacInnes & Stone 2008). As children develop and their mobility increases, the hazards they are exposed to change. Before children have the ability to properly assess the risks involved in new activities and avoid potential dangers, they are particularly vulnerable to injury (AIHW: Pointer 2014).
Emotional turmoil is common, sometimes leading to self-injurious behaviour, as is an increase in risk-taking behaviours, particularly among boys (Martin et al. 2010; Spear 2000). Over time, a child’s ability to make decisions about their safety increases. Injuries sustained among older children are increasingly influenced by behaviour in addition to their physical and social environment.
Injuries sustained during childhood can have profound and lifelong effects on health and development, by causing permanent physical disabilities or long-term cognitive or psychological damage (for example, traumatic brain injury) (Gabbe et al. 2014).
Almost all life lost in infancy and early childhood was due to infant-related diseases, such as birth trauma and asphyxia, pre-term/low birthweight complications, sudden infant death syndrome and other disorders of infancy (AIHW 2016). From ages 5–14, the predominant causes of life lost were injuries and cancer. Injuries to motor vehicle occupants from road traffic injuries, other road traffic injuries and other cancers were the main causes of life lost for males (AIHW 2016). For females, brain cancer and road traffic injuries to motor vehicle occupants were leading causes of life lost in this age group (AIHW 2016).
Childhood deaths and hospitalisations as a result of injury are preventable and can be effectively reduced through the implementation of prevention strategies. Some of the strategies for preventing childhood injury include child-resistant containers, seatbelts and fencing around pools (Harvey 2009).
Do child injury death rates vary across population groups?
In 2014–16, injuries contributed to 547 deaths of children aged 0-14―a rate of 4.1 per 100,000 children. Overall, boys were 1.1 times more likely to die from injury than girls (5.7 compared to 5.1 per 100,000 population), although there was some variation by age group. Children (0–4 year olds) had the highest rate of injury death (6.8 per 100,000 children) compared to older children (5–9 years and 10–14 years accounting for 3.2 and 6.4 per 100,000 of children injury death, respectively).
For the period 2012-16, injury death rate among Indigenous children was 5.7 times as high as the rate for non-Indigenous children (24.4 compared to 4.3 per 100,000). During the same period, the injury death rate in Outer regional, remote and very remote areas (18.5 per 100,000 children) was 4.1 times higher than in Major cities and 2.8 times higher than in Inner regional areas (4.5 and 6.6 per 100,000 children, respectively). Children in the lowest socioeconomic areas also experienced higher injury death rates than those in the highest socioeconomic areas (11.2 injury deaths compared to 2.6 per 100,000 children, respectively).
Has there been a change over time?
The rate of injury deaths has gradually decreased between 2004-06 and 2014–16 from 6.2 per 100,000 children to 4.1 per 100,000 children. The injury death rate for boys was around 1.5 times as high as the rate for girls in 2004-06; however, this has declined to around 1.1 times the rate for girls in 2014-16. Children aged 0-4 years had consistently higher rates than the other age groups over this period but the rate has been gradually declining from 11 per 100,000 children in 2004–06 to 6.8 per 100,000 in 2014–16.
The injury death rate for Indigenous children has risen slightly from 15.3 per 100,000 children in 2005-09 to 24.4 per 100,000 children in 2012-16. Injury death rates for children living in Outer regional, remote and very remote areas were similar for the two periods reported: 2009-13 and 2012-16 (18.4 and 18.5 per 100,000 respectively).
Data by Indigenous status, remoteness and socioeconomic position are calculated using data for a five-year period for data quality reasons (small numbers). This aligns with the reporting for sex and age (which use a three-year period) as follows:
|Sex and age||Indigenous status, Remoteness, Socioeconomic position|
Causes of death are classified according to the International Classification of Diseases and Related Health Problems, 10th revision (ICD-10). Injury deaths include ICD-10 multiple cause of death (S00-T75 or T79) or underlying cause of death (V01-Y36, Y85-Y87 or Y89).
- AIHW (Australian Institute of Health and Welfare) 2016. Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2011. Australian Burden of Disease Study series no. 3. BOD 5. Canberra: AIHW.
- AIHW: Pointer S 2014. Hospitalised injury in children and young people 2011–12. Injury research and statistics series no. 91. Cat. no. INJCAT 167. Canberra: AIHW.
- Flavin MP, Dostaler SM, Simpson K, Brison RJ & Pickett W 2006. Stages of development and injury patterns in the early years: a population-based analysis. BMC Public Health 6:187.
- Gabbe BJ, Brooks C, Demmler JC, Macey S, Hyatt MA, Lyons RA 2014. The association between hospitalisation for childhood head injury and academic performance: evidence from a population e-cohort study. Journal of Epidemiology Community Health 68: 466-470.
- Harvey A, Towner E, Peden M, Soori H, Bartolomeos K (2009). Injury prevention and the attainment of child and adolescent health. Bulletin of the World Health Organization 87:390-394.
- MacInnes K & Stone DH 2008. Stages of development and injury: an epidemiological survey of young children presenting to an emergency department. BMC Public Health 8:120.
- Martin G, Swannell SV, Hazell PL, Harrison JE, Taylor AW 2010. Self-injury in Australia: a community survey. Medical Journal of Australia 193: 506–510.