TY - JOUR

T1 - National five-year examination of inequalities and trends in emergency hospital admission for violence across England

AU - Bellis, Mark A

AU - Hughes, Karen

AU - Wood, Sara

AU - Wyke, Sacha

AU - Perkins, Clare

PY - 2011/10

Y1 - 2011/10

N2 - OBJECTIVES: To examine relationships between violence, age (0-74 years), and deprivation, and to explore in which communities, age groups, and gender the potential for transmission of violent tendencies between individuals is greatest.METHODS: Five year (2004/2005 to 2008/2009) ecological study of emergency admissions resulting from violence (n=170074) into all English hospitals using trend and logistic regression analyses.RESULTS: Hospital admissions for violence peak as individuals achieve legal adulthood (18 years). Risks of admission increase exponentially with increasing quintile of deprivation of residence, with odds overall being 5.5 times higher in the poorest quintile compared with the richest. The greatest absolute difference in violence admissions by deprivation quintile is seen in males aged 18 (218/100 000, richest; 698/100 000, poorest). However, the highest deprivation rate ratios (quintile 5:1) are seen at ages 0-10 years in both sexes and at all ages after 40 years in males (40-58 years, females). In males aged 17-19 years, violence accounts for 20% of the entire gap between wealthiest and poorest quintiles in all cause emergency hospital admissions.CONCLUSIONS: Analyses identify four lifetime periods for violence: up to 10 years (prepubescent), 11-20 years (adolescence), 21-45 years (younger adults), and over 45 years (older adults). While violence is most common in adolescence, its concentration in poorer areas during prepubescence and in younger adulthood (parenting age) suggests that poorer children are exposed to much more aggressive communities. This is likely to contribute to the disproportionate escalation in violence they experience during adolescence. Effective interventions to prevent such escalations are available and need to be implemented particularly in poor communities.

AB - OBJECTIVES: To examine relationships between violence, age (0-74 years), and deprivation, and to explore in which communities, age groups, and gender the potential for transmission of violent tendencies between individuals is greatest.METHODS: Five year (2004/2005 to 2008/2009) ecological study of emergency admissions resulting from violence (n=170074) into all English hospitals using trend and logistic regression analyses.RESULTS: Hospital admissions for violence peak as individuals achieve legal adulthood (18 years). Risks of admission increase exponentially with increasing quintile of deprivation of residence, with odds overall being 5.5 times higher in the poorest quintile compared with the richest. The greatest absolute difference in violence admissions by deprivation quintile is seen in males aged 18 (218/100 000, richest; 698/100 000, poorest). However, the highest deprivation rate ratios (quintile 5:1) are seen at ages 0-10 years in both sexes and at all ages after 40 years in males (40-58 years, females). In males aged 17-19 years, violence accounts for 20% of the entire gap between wealthiest and poorest quintiles in all cause emergency hospital admissions.CONCLUSIONS: Analyses identify four lifetime periods for violence: up to 10 years (prepubescent), 11-20 years (adolescence), 21-45 years (younger adults), and over 45 years (older adults). While violence is most common in adolescence, its concentration in poorer areas during prepubescence and in younger adulthood (parenting age) suggests that poorer children are exposed to much more aggressive communities. This is likely to contribute to the disproportionate escalation in violence they experience during adolescence. Effective interventions to prevent such escalations are available and need to be implemented particularly in poor communities.

KW - Adolescent

KW - Adult

KW - Age Distribution

KW - Aged

KW - Child

KW - Child, Preschool

KW - Emergency Medical Services

KW - England

KW - Female

KW - Hospitalization

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Logistic Models

KW - Male

KW - Middle Aged

KW - Poverty Areas

KW - Risk Factors

KW - Violence

KW - Wounds and Injuries

KW - Young Adult

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1136/ip.2010.030486

DO - 10.1136/ip.2010.030486

M3 - Article

C2 - 21393417

VL - 17

SP - 319

EP - 325

JO - Injury Prevention

JF - Injury Prevention

SN - 1475-5785

IS - 5

ER -