142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Census-based socioeconomic measures and injury risk: A systematic review

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Nathaniel Bell, PhD , College of Nursing, University of South Carolina, Columbia, SC
Amanda Arrington, MD , Department of Surgery, University of South Carolina, Columbia, SC
Swann Arp Adams, PhD , College of Nursing, University of South Carolina, Columbia, SC

Monitoring socioeconomic disparities in risk is an important component of injury prevention and control. However, there is no standard in the US for characterizing the socio-economic profile of geographic areas for purposes of monitoring the relationship between social inequalities and rates of injury. This study systematically reviews and appraises publications that utilize census-based socioeconomic variables to assess disparities in injury risk.


Studies between 1970 and 2013 were included if they used at least one census-based indicator of socioeconomic status (SES) to assess intentional or unintentional injury rates as defined from hospital or trauma-based registries. In total, 82 published studies met the inclusion criteria. Studies were assessed for an inverse relationship between SES and injury. Each measure was re-constructed and assessed against South Carolina state trauma registry data. Age standardized relative risk ratios across SES strata are reported and contrasted.


We identified from the literature 38 different individual or aggregate combinations of census-derived socioeconomic variables. Exploratory summaries and graphs of each census-based indicator and incidence of intentional and unintentional injury (by cause) are presented. The strength of relationship between each indicator and injury is assessed. Linear and generalized linear regression models contrasting injury rates by the individual predictor variables are presented.


This review assesses the diversity of census-based socioeconomic variables thus far used to measure disparities in injury risk. The variability in how social and economic conditions are measured influences the comparability of studies. A recommendation for standard measures for monitoring social gradients in injury risk is presented.

Learning Areas:

Public health or related research

Learning Objectives:
Name the census-based socioeconomic variables that best measure the social gradient in injury risk.

Keyword(s): Risk Factors/Assesment, Health Disparities/Inequities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: My doctorate degree and post-doctorate training was funded through federal (Canadian Institutes for Health Research) and provincial (Michael Smith Foundation) scholarships and fellowships. I have over seven years experience utilizing and developing census-based deprivation indices to asses social gradients in injury risk. In 2012 I served as a panel member for a seminar entitled “Using Area-based Socio-economic Measures to Measure, Monitor and Improve Disparities in Health” during the Canadian Public Health Association annual meeting.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.