Social aetiology of violent deaths in Swedish children and youth.

STUDY OBJECTIVE To describe the contribution of social conditions for the main causes of injury deaths in Swedish children and youth aged 5-25 years. DESIGN Cohort study. All children below 15 years of age that resided in Sweden 1985 were followed up during 1991-1995. Injury deaths were recorded from The National Cause of Death Register. Information on parental social determinants were collected from various national registers. Connections between the social determinants and an injury death outcome were analysed in multivariate Cox regression models. MAIN RESULTS In total 1474 injury deaths were recorded during approximately 8 million person years. In a regression model, with control for sex, year of birth, and residency (urban/rural), the aetiological fraction for parental SES, maternal country of birth, family situation, parental risk factors, and all these factors combined were 13%, 6%, 1.4%, 1.3%, and 19%, respectively. Similar regression models were studied separately for each of the main causes of injury death. The parental social determinants explained 58% of all homicides, 47% of all motor traffic injuries, and 30% of all other traffic injuries while the suicide rate was not affected by these determinants. Parental socioeconomic status was the single most important parental determinant for all major causes of injury. CONCLUSIONS There was a wide variation of the aetiological fractions of parental social determinants for different causes of injury death. This variation might be used to further investigate the social aetiology of injuries.