Rocío Palmera-Suárez1, Teresa López-Cuadrado2, Rafael Fernández-Cuenca3, Enrique Alcalde-Cabero4, Iñaki Galán5. 1. Department of Epidemiological Analysis and Health Status, National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029, Madrid, Spain. Electronic address: rpalmera@externos.msssi.es. 2. Department of Epidemiological Analysis and Health Status, National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Autonomous University of Madrid/IdiPAZ (Instituto de Investigación del Hospital Universitario La Paz/La Paz University Teaching Hospital Research Institute), Calle del Arzobispo Morcillo 4, PC 28029, Madrid, Spain. Electronic address: teresalc@isciii.es. 3. Department of Epidemiological Analysis and Health Status, National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029, Madrid, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029, Madrid, Spain. Electronic address: rfcuenca@isciii.es. 4. Department of Applied Epidemiology, National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029, Madrid, Spain. Electronic address: ealcalde@isciii.es. 5. Department of Applied Epidemiology, National Centre for Epidemiology, Carlos III Institute of Health, Calle Monforte de Lemos 5, Pabellón 12, PC 28029, Madrid, Spain; Department of Preventive Medicine and Public Health, School of Medicine, Autonomous University of Madrid/IdiPAZ (Instituto de Investigación del Hospital Universitario La Paz/La Paz University Teaching Hospital Research Institute), Calle del Arzobispo Morcillo 4, PC 28029, Madrid, Spain. Electronic address: igalan@isciii.es.
Abstract
BACKGROUND: Although traffic injuries (TIs) are an important cause of disability the related factors are little known. We aimed to estimate the differences in risk of TI-related disability according to individual characteristics that might generate health inequalities. METHODS: Cross-sectional study using a representative Spanish population sample drawn from the European Health Interview Survey 2009/2010. We calculated traffic crashes in the preceding year which resulted in injuries. Disability was measured using the Global Activity Limitation Indicator and four indicators of limitations (sensory, physical functional, self-care and domestic activities). Principal socio-demographic and behavioural/lifestyle variables were studied. We used multivariate logistic regression to estimate the risk (ORs) of TI-related disability in the sample as whole and disability-related factors in persons who had experienced TIs. RESULTS: Persons with TIs had a higher risk of global disability (OR = 1.61; 95%CI:1.17-2.20), physical functional limitations (OR = 1.96; 95%CI:1.33-2.89) and self-care limitations (OR = 1.73; 95%CI:0.98-3.05). Among persons with TIs, GALI-related risk was higher in women (OR = 3.06, p = 0.002) and persons aged over 30 years (OR31-45years = 6.81, p < 0.001; OR46-64years = 5.96, p = 0.011; OR>64years = 4.54, p = 0.047). Lower risk was observed among persons with a higher educational level (OR = 0.22, p = 0.003). The risk of disability among persons with TIs who consumed illegal drugs was OR = 3.9 (p = 0.023). CONCLUSIONS: Traffic injuries in the preceding year are associated with higher risk of disability, which is unevenly distributed. Individual (women and persons over 30 years), socio-economic (lower educational level) and behavioural (illegal drug use) factors are involved. Actions aimed at changing the unequal risk among vulnerable subgroups and providing health, social and protective services should be implemented.
BACKGROUND: Although traffic injuries (TIs) are an important cause of disability the related factors are little known. We aimed to estimate the differences in risk of TI-related disability according to individual characteristics that might generate health inequalities. METHODS: Cross-sectional study using a representative Spanish population sample drawn from the European Health Interview Survey 2009/2010. We calculated traffic crashes in the preceding year which resulted in injuries. Disability was measured using the Global Activity Limitation Indicator and four indicators of limitations (sensory, physical functional, self-care and domestic activities). Principal socio-demographic and behavioural/lifestyle variables were studied. We used multivariate logistic regression to estimate the risk (ORs) of TI-related disability in the sample as whole and disability-related factors in persons who had experienced TIs. RESULTS:Persons with TIs had a higher risk of global disability (OR = 1.61; 95%CI:1.17-2.20), physical functional limitations (OR = 1.96; 95%CI:1.33-2.89) and self-care limitations (OR = 1.73; 95%CI:0.98-3.05). Among persons with TIs, GALI-related risk was higher in women (OR = 3.06, p = 0.002) and persons aged over 30 years (OR31-45years = 6.81, p < 0.001; OR46-64years = 5.96, p = 0.011; OR>64years = 4.54, p = 0.047). Lower risk was observed among persons with a higher educational level (OR = 0.22, p = 0.003). The risk of disability among persons with TIs who consumed illegal drugs was OR = 3.9 (p = 0.023). CONCLUSIONS: Traffic injuries in the preceding year are associated with higher risk of disability, which is unevenly distributed. Individual (women and persons over 30 years), socio-economic (lower educational level) and behavioural (illegal drug use) factors are involved. Actions aimed at changing the unequal risk among vulnerable subgroups and providing health, social and protective services should be implemented.