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Does the home environment influence inequalities in unintentional injury in early childhood? Findings from the UK Millennium Cohort Study
  1. A Pearce1,
  2. L Li1,
  3. J Abbas2,
  4. B Ferguson2,
  5. H Graham3,
  6. C Law1
  1. 1Centre for Paediatric Epidemiology and Biostatistics, UCL Institute of Child Health, University College London, London, UK
  2. 2Yorkshire and Humber Public Health Observatory, York, UK
  3. 3Department of Health Sciences, University of York, York, UK
  1. Correspondence to Anna Pearce, UCL Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK; a.pearce{at}


Background Children from disadvantaged backgrounds are more likely to experience unintentional injuries and poor home environments. The aim of this study was to explore the home environment as a potential mediator between socioeconomic circumstances and unintentional injuries, in the UK Millennium Cohort Study (n=14 378).

Methods RRs and 95% CIs for being injured in the home between age 9 months and 3 years were estimated according to four measures of socioeconomic circumstances: social class, maternal education, lone parenthood status and tenure. Proxy indicators of housing quality (build type, storey, garden access, rooms per capita, central heating and presence of damp) and safety equipment use (use of fireguards, safety gates, electric socket covers and smoke alarms) were then controlled for in order to observe potential mediation.

Results Children from routine and manual backgrounds were more likely to be injured than those from managerial and professional backgrounds (RR=1.33, 95% CI 1.21 to 1.47), as were children of lone parents (compared with couple families) (RR=1.23, 95% CI 1.12 to 1.36), those whose mothers had no educational qualifications (compared with a degree) (RR=1.42, 95% CI 1.24 to 1.63) and those living in socially rented accommodation (compared with owned/mortgaged homes) (RR=1.35, 95% CI 1.24 to 1.46). However, controlling for the indicators of housing quality and safety equipment use did not alter the elevated risk of injury experienced by children from less advantaged backgrounds.

Conclusions In this contemporary UK cohort, proxy indicators of the home environment did not appear to explain socioeconomic inequalities in injuries. Research exploring alternative explanations for inequalities in injuries could help contribute to the design or adaptation of policies to reduce them.

  • Child accidents
  • housing and health
  • social inequalities

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  • Funding This work was undertaken as part of the Public Health Research Consortium. The Public Health Research Consortium is funded by the Department of Health Policy Research Programme. The views expressed in the publication are those of the authors and not necessarily those of the Department of Health. Information about the wider programme of the PHRC is available from LL is funded by a Medical Research Council Career Development Award in Biostatistics. The Centre for Paediatric Epidemiology and Biostatistics was supported in part by the Medical Research Council in its capacity as the MRC Centre of Epidemiology for Child Health. Research at the UCL Institute of Child Health and Great Ormond Street Hospital for Children receives a proportion of the funding from the Department of Health's National Institute for Health Research Biomedical Research Centres funding scheme. The Millennium Cohort Study is funded by grants to Professor Health Joshi, Director of the study from the Economic and Social Research Council and a consortium of government funders. The study sponsors played no part in the design, data analysis and interpretation of this study, the writing of the manuscript, or the decision to submit the paper for publication and the authors' work was independent of their funders.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.