The study examines the relationship between country of birth, socioeconomic position, and the risk of being injured as a young car driver.
The study consists of a nationwide follow-up of young people in Sweden in which individual census records on country of birth and household socioeconomic position were linked to the Hospital Discharge Register so as to identify subjects' road traffic injuries (RTIs) as car drivers. Multivariate analyses were conducted using Cox regression, with hospital admission due to RTI as car driver as the dependent variable.
There are no significant differences in injury risks between foreign-born and Swedish-born drivers, but clear socioeconomic differences were found. Young drivers from manual worker families have 80% higher risk for RTIs compared to drivers in families with salaried employee parents (RR 1.83, CI 1.63-2.05).
The results do not support the idea that type of country of origin constitutes a significant marker of risk level for RTI as novice car driver. On the other hand, the results reconfirm that, in Sweden, the risk of RTI among young drivers from different socioeconomic backgrounds varies.
A national register-based cohort study was conducted to explore whether the social patterning of car drivers suffering injury repetitions differs from that of once-injured drivers in a cohort of young persons in Sweden (aged 18-26). Injury repeaters were defined as individuals sustaining injuries as a car driver on more than one occasion over an 8-year period. Only subjects obtaining a driver's licence before the age of 27 were included in the study. The social variables considered were, in turn, gender, socioeconomic position of origin, and own educational attainment. Attention was also paid to age at licensing. Two types of comparisons were made, using odds ratios with 95% confidence intervals. First, the odds of injury repeaters were computed using the once-injured car drivers as a reference group. Second, odds were compiled for once, twice, and three or more times injured people, using the non-injured at all as a comparison group. The results show that, by and large, the injury-risk distribution of car drivers with injury repetition does not differ from that of one-injury drivers with regard to gender, education, or socioeconomic group. However, drivers from self-employed households show greater odds of injury repetition (OR 1.65, CI 1.02-2.67) than of one injury compared with drivers from the families of non-manual employees. Since the number of injury repeaters is low and their socioeconomic distribution is very similar to that of the once injured, there is no need to regard them as a group at excess risk or different from the one-time injured. Reducing risk levels and risk differentials for the one time injured should therefore receive priority with regard to traffic-injury prevention.
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.
The study aims to clarify the most typical circumstances in which car crashes involving young drivers and leading to the occurrence of injuries and to consider the various licensing statuses of the drivers in such crashes.
Young Swedish drivers born between 1984 and 1986 were followed up in the Police register (2003-2004) for their involvement in car crashes as drivers (n=2448). A set of five variables (25 categories) descriptive of those crashes was analyzed simultaneously by means of cluster analysis. Associations between crash clusters and licensing status (including none), licensing duration and alcohol involvement were also measured.
Five clusters were identified, typical of one or some specific crash type(s): single-vehicle in sparsely populated areas, front-on collisions, crashes at dawn or at dusk, turning, cars of later model, crashes in urban areas and speed limits below 50 km/h. Clusters differ in consequences and in the proportions of alcohol impaired drivers involved but not regarding proportions of novice drivers. Unlicensed drivers were found in excess in some clusters (especially single and night time crashes).
Young drivers are involved in crashes leading to injuries in rather specific circumstances. For some of them, novice drivers or even unlicensed drivers are over-represented, which points to the need for targeted counter-measures, alongside those general ones already in place.
Children's independent everyday mobility can be hindered by fears experienced in their neighborhood. The aim of this study is to assess the prevalence and determinants of such fears among boys and girls in early adolescence, a period when individual freedom is expected to be on the increase. A sample of 7th grade students (age-13 years) in Stockholm County, Sweden, during 2005/06 answered a survey in class (n = 1,008). The relation that gender, housing, family characteristics, individual and peer negative experiences in the neighborhood, parental licensing, and length of stay in the neighborhood have with fear disclosure was assessed through multivariate logistic regression. A total of 60% of the girls and 40% of the boys reported experiencing fears in their neighborhood. Gender differences were significant for all of the most common fears, in particular darkness. When respondents or their friends had been chased, hit, or had something taken from them in their neighborhood, they were more likely to report fear (OR girls 2.3; 95% CI 1.6-4.5; boys 2.8; 95% CI 1.9-4.2). For girls, having one or more parents born outside Sweden was associated with fear. Boys nearly three times more often reported fear if (a) they thought their parents were negative toward adolescent independent mobility in the evening, or (b) they had lived longer than one year in their area. Many young adolescents admitted to experiencing fear in their neighborhood. Fears were more common among girls, and the types and determinants of fear seem to be gender specific.
Active commuting to school by walking or cycling can have positive impact on children's health and development. The study investigates the prevalence of active commuting to school in Sweden, a setting where it is facilitated and promoted; and how active commuting varies according to socio-demographic and socio-economic characteristics.
Self-reports from a national sample of Swedish children (11- to 15-year-olds, n = 4415) and a regional one from Stockholm County (13-year-olds, n = 1008) on transport to school were compared. The association that active commuting has with socio-demographic (gender, school grade, Swedish origin, type of housing, urbanicity in the local area), and socio-economic characteristics (household socio-economic status, family car ownership) was studied using logistic regression, controlling for car ownership and urbanicity, respectively.
Active commuting was high (62.9% in the national sample) but decreased with age-76% at the age of 11 years, 62% at the age of 13 years and 50% at the age of 15 years-whereas public transport increased (19-43%). Living in an apartment or row-house (compared with detached house) and living in a medium-sized city (compared with a metropolitan area) was associated with active commuting. In urban areas, active commuting was more common in worker households compared with intermediate- to high-level salaried employees.
Active commuting is common but decreases with age. Active commuting differed based on housing and urbanicity but not based on gender or Swedish origin, and impact of socio-economic factors differed depending on level of urbanicity.
The study examines whether there are socioeconomic differences between young adult car drivers involved in road-traffic crashes with regard to crash-injury severity and crash circumstances. Differences in social patterning based on socioeconomic position (SEP) of origin and of destination, and also the effect of gender, are considered. Subjects born in 1970-1972 were extracted from the Swedish Population and Housing Census of 1985 (n = 329,716). Individual records from the 1985 census were linked to road-traffic data for the period 1988-2000 on the basis of a search for each subject's first police-registered road-traffic crash as a car driver (n = 12,502). Information on household socioeconomic group was taken from the census of 1985, and data on completed education at age 28-30 were gathered from Sweden's Register of Education. Two categories of crash severity were analysed (minor/no injury and severe/fatal injury), and also five crash circumstances (based on a classification of five crash descriptors). Both crash severity and crash circumstances are unequally distributed across social groups among young adult drivers. Social patterning is more pronounced for severe injuries/fatalities, and is consistently so across crash circumstances depending on SEP of destination, particularly for males. Socioeconomic differences are more pronounced for crash circumstances characterised as front-on and overtaking collisions and for single-vehicle crashes (43% of total crashes). In conclusion,the excess risk of young drivers from lower socioeconomic groups is consistent over crash severity but more pronounced as severity increases and for certain crash circumstances.
Children's independent mobility differs between groups of adolescents, but knowledge is lacking on how mobility-limiting factors interact. This study explores the association between factors that can affect young adolescents' mobility, searching for typical patterns within a geographical area where mobility is both relatively high and promoted (in this case Stockholm County, Sweden). An additional question is how clusters of limiting factors and demographic attributes relate to active commuting to school.
A sample of 7th grade students (ca 13-14 years old) in Stockholm County, Sweden, answered a survey (n = 1008). A cluster analysis was performed on variables descriptive of the respondents and of potential limitations to their independent mobility, such as fears, coping, traffic situation in the neighbourhood and parent/child opinions on mobility (18 variables and 50 categories). Active commuting to/from school was compared using proportion (with 95% confidence intervals) by cluster.
Five consistent and distinct clusters were identified. Among the most discriminating factors were fears experienced in the neighbourhood, strategies to cope with fear, type of housing and traffic environment. Girls were over-represented in the two clusters most typical of respondents experiencing fears (either several of these or darkness in particular) and boys in two others where housing (house vs. apartment) and neighbourhood conditions played a more determinant role. The proportion of active commuting among respondents was quite similar over clusters but was nonetheless higher in the cluster (over girls) reporting more fears and other factors limiting mobility.
Whereas fears--and coping--are more typical of adolescent girls in the formation of the clusters, household and neighbourhood characteristics are more typical of boys. Broadly speaking, there seem to be two groups of girls with fears but these differ based on types of fear, ways of coping with fear and their living conditions. The association between the limitations to mobility and active commuting is unclear, the latter being higher among those disclosing a broader range of limiting factors, including fears.
Sweden has had a restrictive alcohol policy, but there are gender and geographical differences in alcohol consumption and injury rates within the country. Whether and how the Swedish alcohol environment influences gender differences in injuries in young people is still unclear. Thus, the aim of this study was to analyse the associations between the local alcohol environment and age- and gender-specific nonfatal injury rates in people up to 24 years in Sweden.
The local alcohol environment from 14 municipalities was studied using indicators of alcohol access, alcohol consumption and alcohol-related crimes. A comprehensive health care register of nonfatal injuries was used to estimate mean annual rates of nonfatal injuries by gender and age group (2000-2005). Pearson's correlation coefficients were used to analyse linear associations.
Associations were shown for both alcohol access and alcohol consumption with injury rates in boys aged 13-17 years; no other associations were observed between alcohol access or per capita alcohol consumption and nonfatal childhood injuries. The prevalence of crimes against alcohol laws was associated with injury rates in children of both genders aged 6-17?years.
This study found no strong area-level associations between alcohol and age and gender specific nonfatal injuries in young people. Further, the strength of the area-level associations varied by age, gender and type of indicator used to study the local alcohol environment.
To understand one of the major public health problems for children, it is important to consider the children's perspective. The purpose of this qualitative study was to explore, describe, and categorize children's perceptions of injury severity and children's explanations of the injuries they experience. A total of 29 students from six randomly selected schools were interviewed in age groups of 9, 13, and 17 years. Manifest content analysis according to Graneheim and Lundman (2004) was used to categorize children's own statements. Need of medical attention, long-term consequences, and familiarity with the injury risk situation were identified as important determinants of children's perception of injury severity. Three categories emerged from children's explanations of their injuries: "Because of Me" (beliefs, lack of concentration, health conditions, and lack of awareness of risk), "Because of the Situation" (rain, ice, wind, animals, inanimate objects, constructions, and the children's games), and "Just Inexplicable" to the children. Findings suggest that children have a wide perception of injury severity and that children's beliefs of injury causation, as well as children's familiarity with injury risk situations, need to be considered in future studies focusing on the development of childhood injury prevention strategies. Additionally, results suggest that sometimes children cannot or do not want to explain their injuries.