Injury Analyses in Rural Children: Comparison of Old-Order Anabaptists and Non-Anabaptists

• Published in: The Journal of trauma, injury, infection, and critical care Vol. 69; no. 5; pp. 1294 - 1299
• Main Authors: Forward, Karen, Chan, Melissa, Stewart, Tanya Charyk, Gilliland, Jason, Campbell, Craig, Fraser, Douglas D.
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-11-2010; Lippincott Williams & Wilkins
• Subjects: Adolescent; Age Factors; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Child; Child, Preschool; Diseases of the osteoarticular system; Female; General anesthesia. Technics. Complications. Neuromuscular blocking. Premedication. Surgical preparation. Sedation; Humans; Incidence; Infant; Infant, Newborn; Injuries of the limb. Injuries of the spine; Injury Severity Score; Male; Medical sciences; Ontario - epidemiology; Protestantism; Retrospective Studies; Rural Population; Traumas. Diseases due to physical agents; Wounds and Injuries - diagnosis; Wounds and Injuries - epidemiology; Wounds and Injuries - prevention & control; Ontario; Human; Prevention; Rural environment; Injury prevention; Adolescent; Rural area; Anesthesia; Rural populations; Child; Trauma; Comparative study
• ISSN: 0022-5282; 1529-8809
• DOI: 10.1097/TA.0b013e3181fa7e25

BACKGROUND:Southwestern Ontario largely comprises rural farming districts and is home to numerous Old-Order Anabaptist settlements. Our objective was to describe the injuries sustained by rural children, both Old-Order Anabaptist and non-Anabaptist, to better target injury prevention programs.
METHODS:We retrospectively examined injury data of rural children in Southwestern Ontario with injury severity scores ≥12 obtained from hospital and trauma databases (1997–2007).
RESULTS:A total of 422 rural children were included in this study7.8% Anabaptist (n = 33) and 92.2% non-Anabaptist (n = 389). The age of injured Anabaptist children (median, 7 years; interquartile range = 10) was younger than non-Anabaptist children (median, 14 years; interquartile range = 7; p < 0.001). Anabaptist children were most frequently injured on their property (48.5%; n = 16 of 33; p < 0.001). Non-Anabaptist children were mostly injured on roads (56.8%; n = 221 of 389; p < 0.05) and by motor vehicle collisions (MVCs; 40.1%; n = 156 of 389; p = 0.02). Frequent causes of injury among Anabaptist children were falls (24.2%; n = 8 of 33; p = 0.02), animals (15.2%; n = 5 of 33; p = 0.004), and buggies (9.1%; n = 3 of 33). Approximately half of both groups injured in MVCs did not use seat belts. There were no significant differences between cohorts in sex, injury severity scores, hospitalization days, rates of complications, interventions, comorbidities, or mortality rates.
CONCLUSIONS:Injuries to Anabaptist children occur at a young age, primarily on their property, and exhibit a unique spectrum of mechanisms. In contrast, injuries to non-Anabaptist children occur at an older age, primarily on roads, and in MVCs. The use of protective devices was low among all rural children. Development of collaborative injury prevention programs targeted to distinct rural communities, including Anabaptist and non-Anabaptist, are needed for reducing injuries among rural children.