University of Auckland: Cluster of disadvantage increases likelihood of pre-school injuries

A cluster of disadvantage contributes to injuries in early childhood, but better support for families could make a difference.


University of Auckland research examined data gathered from more than 6,000 families participating in this country’s largest longitudinal study, Growing Up in New Zealand.

The study, funded by the Ministry of Social Development’s Child and Families Research Fund, found that nearly half of children experience some form of injury requiring medical attention before they turn five-years-old.

Injury is the leading cause of child death and hospitalisation in Aotearoa-New Zealand and the Accident Compensation Corporation spends more than $175million a year to cover child injuries.

Lead researcher Associate Professor Bridget Kool says children living in families that experience high stress and deprivation appear to have much greater risk of injury in the pre-school years.

“This research shows that a multitude of factors influence risk for childhood injuries, ranging from social, environmental and behavioural. It is not something that can always be directly attributed to parenting or parenting ability,” she says.

“Our study shows that policies which reduce poverty and inequalities in socio-economic status and which directly impact household income and material deprivation could also have the added benefit of reducing childhood injuries.”

The research examined data from Growing Up in New Zealand children at two years of age and again at four-years of age and gathered details about injuries they had sustained, their household living environment (including safety features), as well as health, social and family data from the antenatal period up to four-years of age.

The researchers discovered that the factors most associated with child injury in the pre-school years were:

A high-needs environment: includes being on a benefit; using social services; moving house; and whether the mother was unemployed.
The living environment: overcrowded conditions; families not owning their own home; and living in damp or mouldy housing.
The family environment: includes having siblings; being a younger sibling; and not having good external support to parent.
High stress households: includes family stress and the mother having postnatal anxiety.
Living in a nurturing environment (including having good access to healthcare services) appears to be a protective factor for children and halves their risk of childhood injury in the pre-school years.

Policies which reduce poverty and inequalities in socio-economic status and which directly impact household income and material deprivation could also have the added benefit of reducing childhood injuries.
Associate Professor Bridget Kool
Associate Professor Kool says, interestingly, household safety measures, such as safe hot water temperature, protected power outlets, smoke alarms, and driveway fencing did not appear to reduce the risk of childhood injury once other factors were considered.

“The relatively low rates of certain safety features, such as fenced off driveways, covered electrical outlets and stair safety, indicates that there is room for improvement in this area.

“We believe consideration should be given to a minimum standard for safety features required in the home, especially for rental properties,” she says.

Associate Professor Kool says the other key risk factor for child injury relates to the temperament and behaviour of the child.

Boys, children who are very active, and those with behavioural difficulties are more likely to experience injury in the pre-school years.

The most common types of injuries for pre-school aged children were injuries to the head, broken bones, injuries to the mouth or teeth, and cuts needing stiches.

Associate Professor Kool says the research is important because it provides a deeper understanding about why inequities in injury outcomes exist and highlights the need for policies which focus on addressing housing and socioeconomic inequalities as a first step to reducing child injury rates.