Spatial Epidemiology of Child and Youth Injury in Canada
The aim of this dissertation is to provide an in depth investigation of pediatric injuries within Canada in order to improve care and tailor prevention strategies to specific populations of Canadian children and youth. Data requested in this Data Access Request (DAR) will be used to conduct analysis in BC only. The specific objectives for this part of the analysis are:
(1) determine the geographical distribution of major traumas within BC child and youth population, describing the hotspots for child and youth injury within BC and identifying disadvantaged populations and high risk injury mechanisms and patterns;
(2) determine the types of injury requiring high level care, the current rate/level at which such injuries receive care, and the barriers that impede access to appropriate care; and,
(3) assess the effectiveness of BC pediatric trauma systems in dealing with these injuries.
The scale of this research introduces several challenges. First, the study is large both geographically and in terms of the population, resulting in datasets that are both large and heterogeneous. The heterogeneity is brought about by differences in local characteristics (e.g. weather patterns) that may affect injury mechanisms in different parts of the Province. Second, the data includes only injury and SES information. Environmental data, like housing types and neighborhood characteristics, which typically need to be collected in person, are not recorded. Therefore, in addition to focusing on the examination of pediatric injuries at the national level, this study will also examine several neighborhoods in the greater Vancouver region, examining the relationship between environmental factors and pediatric injuries. However, Analysis of specific neighborhood as it pertains in the ethics approval will not be performed within the scope of the research done with the data requested in this DAR. This analysis will be done using aggregated data and its not within the scope of the analysis that will be done with the data requested in this DAR.
Three main research questions, each to be addressed within its own chapter, will serve as guides for this study:
1) Where are the hotspots for pediatric injury with BC? Are children with low socio economic status (SES) more likely to be injured? If so, are certain injury mechanisms more prevalent in children of low SES?
2) How effective is BC pediatric trauma system in providing care to injured children? Are the right patients getting to the right places? What types of injuries are best treated in pediatric trauma centers (as opposed to adult trauma centres)?
3) Can geographic access to a pediatric trauma center affect outcome? Can we identify locations where populations have both high susceptibility to injury and poor geographic access to trauma care?