Abstract
This report presents hospitalisation data for unintentional injuries among children and young people (0-24 years) and includes injuries that were the result of falls, transport accidents, burns, and near drownings, among other causes. A separate, companion report details the burden of intentional injury (abuse, assault, and neglect) among children and young people.
Unintentional injuries represent the leading cause of hospital presentation and admission for children and young people living in Aotearoa. In the five years from 2018 to 2022, there were nearly 150,000 hospitalisations for unintentional injuries among children and young people aged 0–24 years. Hospitalisation rates for unintentional injuries have remained largely unchanged over the last two decades. Whilst some injuries may resolve quickly, other injuries may have lifelong physical, social, and economic implications for children, young people, and their whānau.
The type and incidence of injury to children and young people varies by age, sex/gender, ethnicity, level of deprivation, and area of residence. The most striking differences are those by age and sex/gender. Injury rates appear to have two peaks, the first occurring among pre-schoolers, but particularly those aged two years or younger, and the second among older adolescents and young adults. For younger children (aged 0–14 years), falls are the leading cause of unintentional injury. For those aged 15 years and older, however, the leading causes of injury are divided more or less equally between falls, transport accidents, and mechanical force injuries (being struck or caught/crushed by objects). These young people are also more likely to require longer hospital stays (up to a week), suggesting that the injuries they sustain are more complex/severe. In terms of differences by sex/gender, up until the age of about 10–11 years, male and female children show a similar pattern in the incidence of injury. However, from this age onwards, a sharp increase among males leads to a marked disparity in injury rates by sex/gender. At age 14, for example, rates among males are nearly double those among females. This disparity remains present until at least the age of 24 years (the upper limit of age in this report).
In terms of ethnicity and socioeconomic deprivation, those of Asian/Indian ethnicity experience the lowest rates of unintentional injury with rates less than half those seen for those of European/Other ethnicity. Low rates for Asian/Indian children and young people are seen across all ages and the marked differences between males and females that exist for other ethnicities are not seen for this ethnic group. Despite the fact that socioeconomic gradients for injury are less pronounced than they are for some other conditions of childhood, children and young people living in the most deprived areas (quintiles 4 and 5) are still over-represented in hospitalisations with rates that are around 10% higher than those living in less deprived areas. These differences are most apparent for taitamariki Māori and for European/Other children and young people. Poor access to care and/or mistrust of the system may mean that fewer children and young people are seen in the hospital setting and are, therefore, under-represented in these statistics.
For all under-25-year-olds, there is some variation in the pattern of injury incidence by geographic location. Pre-school aged children living in Auckland and Waikato have higher rates of unintentional injury compared with the national average. Falls and injuries resulting from mechanical forces account for the majority of these injuries. Canterbury has the lowest overall rates of hospitalisation for this type of injury in the country and this appears to be consistent across all age groups.
Aotearoa ranks poorly among comparable OECD countries in terms of health and safety for children and young people. This has been attributed to gaps in injury prevention policy development but also in the implementation of safety measures supported by high-quality evidence. The risk of injury is multi-factorial and exists at the level of the individual, the family, and the environment. Research highlights the importance of targeting interventions to specific populations at risk from assorted causes of injury, and the need for multi-sectorial cooperation.