邻里社会和物质剥夺导致小儿虐待性头部创伤的不平等：加拿大不列颠哥伦比亚省的人口水平研究,Child Maltreatment

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邻里社会和物质剥夺导致小儿虐待性头部创伤的不平等：加拿大不列颠哥伦比亚省的人口水平研究
Child Maltreatment ( IF 4.5 ) Pub Date : 2019-12-12 , DOI: 10.1177/1077559519892332
Emilie Beaulieu _{1,

2} , Andy Jiang ₃ , Alex Zheng ₁ , Fahra Rajabali ₁ , Ian Pike _{1,

2}

Affiliation

目的：探讨社区社会和物质剥夺与虐待性头部创伤 (AHT) 发生率之间的关系，以及它是否因性别而异，并遵循“紫色哭泣期”(PURPLE) 计划的实施。方法：横断面研究设计应用于 2005 年至 2017 年不列颠哥伦比亚省 0 至 24 个月大且确诊 AHT 的儿童的数据。基于传播地区的社会和物质剥夺分数被分配到居住区，在那里记录了 AHT 案例。泊松回归模型测试了剥夺分数与 AHT 率之间的关系，将性别和项目实施前后作为交互项。结果：随着物质和社会剥夺五分位数的增加，AHT 率增加 42%（95% CI [1.18, 1.72]）和 25%（95% CI [1. 06, 1.51])，分别遵循社会梯度。实施 PURPLE 计划后，社区之间的 AHT 比率差异没有改变。结论：本研究强调，除了普遍的 AHT 计划外，还需要根据邻里劣势水平提供额外的 AHT 预防服务，以成功保护所有儿童。

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Inequities in Pediatric Abusive Head Trauma According to Neighborhood Social and Material Deprivation: A Population-Level Study in British Columbia, Canada

Objectives: To explore the relationship between neighborhood social and material deprivation and the rates of abusive head trauma (AHT), and whether it differs according to sex, and following the implementation of the Period of PURPLE Crying (PURPLE) program. Method: A cross-sectional study design was applied to data from children 0 to 24 months old with a confirmed AHT diagnosis between 2005 and 2017 in British Columbia. Dissemination area–based social and material deprivation scores were assigned to residential areas, where AHT cases were recorded. Poisson regression models tested the relationship between deprivation scores and AHT rates, adding sex and pre–post program implementation as interaction terms. Results: With each increase in material and social deprivation quintiles, AHT rates increased by 42% (95% CI [1.18, 1.72]) and 25% (95% CI [1.06, 1.51]), respectively, following a social gradient. AHT rate disparities between neighborhoods did not change following the PURPLE program implementation. Conclusions: This study stresses the need to provide additional AHT prevention services proportionately to the levels of neighborhood disadvantage, in addition to universal AHT programs, to successfully protect all children.

更新日期：2019-12-12

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