Routine screening of children returning home from the tropics: retrospective study.

Despite overall improvements in childhood mortality from injury in England and Wales, children in the lower socioeconomic groups seem to be experiencing progressively increasing relative risks of injury in comparison with those in higher socioeconomic groups, possibly as a result of a differential impact of health education efforts. Our data suggest that this may not be the case in Scotland. The reason for this difference north and south of the border is unclear. One hypothesis is that, unlike in England and Wales, measures to prevent injury in children are exerting an equal effect on all socioeconomic groups in Scotland. An alternative explanation is that the decline has occurred independently of specific preventive efforts. We cannot rule out the possibility that the cross border differences are due to the way socioeconomic status is measured. The Carstairs’ deprivation scores adopted in Scotland and the social class definitions used in the analysis of England and Wales data are not necessarily directly comparable. The Carstairs system adopts a measure of “area” deprivation, whereas the measure of social class used in England and Wales categorises the population into five classes based on individual occupational status. This may be important as there is some evidence that the characteristics of communities, as well as those of individuals, exert an impact on the health of the population. Further investigation of the apparently divergent socioeconomic patterns of mortality from injury in children within the United Kingdom is necessary.