Marie Hasselberg

Aim: To investigate the social risk distribution and improvement potentials for road traffic injuries among Swedish children by considering three categories of road users. Methods: A population-based cohort study of children aged 1–14 y was carried out. Subjects were taken from the Swedish Population and Housing Census of 1990 (n= 1 406405), and followed-up in the National Hospital Discharge Register for the years 1991–1999 focusing on injuries incurred as pedestrians, bicyclists or car passengers (n= 16084). Household socio-economic position was measured using social class, education and disposable income. Relative risks were calculated using Poisson regression for each measure of socio-economic position and by combining them, adjusting for sex, age of child and age of mother at delivery. Population-attributable risks were compiled for each category of road user and each measure of socio-economic position. Results: Children of farmers and the self-employed are at greater risk for injuries as car passengers (RR 2.40, CI 1.79–3.20 and RR 1.44, CI 1.16–1.79, respectively), but not for pedestrian- and bicycle-related injuries. Children of unskilled workers are at greater risk for pedestrian injuries (RR 1.39, CI 1.15–1.67). Controlling for education and disposable income did not affect the relative risks to the same extent according to the social class and category of road user. The highest population-attributable risks were related to family disposable income and were indicated for pedestrians and car passengers (19–20%). Conclusion: By taking children's limited ability to deal with different types of traffic situations into consideration, considerable improvements in children's risk levels have been observed. Now there is a need to add equity in the road traffic safety equation.

The aim of this study is to explore the manner in which different measures of original socioeconomic position (SEP) influence road traffic injuries (RTIs) among young car drivers in Sweden. The study consists of young people age 16-23. Subjects were taken from the Swedish Population and Housing Census of 1990 ( n = 727,995), and followed up by a search for cases of injury to car drivers in Sweden's National Hospital Discharge Register over the years 1991-96 ( n = 1,599). Household SEP was measured using social class, education, and disposable income. Relative risks were estimated by Poisson regression and population attributable risks were computed for each measure of SEP. Children of unskilled workers, of the self-employed, and of farmers, as well as children of parents with compulsory education only showed an increased risk of injury as car drivers compared to children in the highest socioeconomic group and children of highly educated parents. By contrast, level of household disposable income was found not to vary with RTI among young drivers. Twenty-five percent of the injuries could be avoided if all young people had the injury rate of the highest socioeconomic group, and 29% if all young people had the injury rate of those with highly educated parents. The reduction of risk differences based on household SEP calls for consideration of factors related to both differential exposure and differential susceptibility, which may be addressed in driver education.