A geospatial analysis of the relationship between neighbourhood socioeconomic status and adult severe injury in Greater Vancouver

BACKGROUND Every year, injuries cost the Canadian healthcare system billions of dollars and result in thousands of emergency room visits, hospitalisations and deaths. The purpose of this study was to explore the relationship between neighbourhood socioeconomic status (NSES) and the rates of all-cause, unintentional and intentional severe injury in Greater Vancouver adults. A second objective was to determine whether the identified associations were spatially consistent or non-stationary. METHODS Severe injury cases occurring between 2001 and 2006 were identified using the British Columbia's Coroner's Service records and the British Columbia Trauma Registry, and mapped by census dissemination areas using a geographical information system. Descriptive statistics and exploratory spatial data analysis methods were used to gain a better understanding of the data sets and to explore the relationship between the rates of severe injury and two measures of NSES (social and material deprivation). Ordinary least squares and geographically weighted regression were used to model these relationships at the global and local levels. RESULTS Inverse relationships were identified between both measures of NSES and the rates of severe injury with the strongest associations located in Greater Vancouver's most socioeconomically deprived neighbourhoods. Social deprivation was found to have a slightly stronger relationship with the rates of severe injury than material deprivation. CONCLUSIONS Results of this study suggest that policies and programmes aimed at reducing the burden of severe injury in Greater Vancouver should take into account social and material deprivation, and should target the most socioeconomically deprived neighbourhoods in Greater Vancouver.