Indigenous people in British Columbia suffered transportation-related injuries at a rate 1.89 times higher than the province's total population between 1991 and 2010, a new University of B.C. study has found.
Overall hospitalization rates for transport injuries in B.C. (including car, bike or pedestrian incidents, and motorcycle, bus, ATV, boat or airplane crashes, as well as others) declined by more than two-thirds during the study period.
"The good news was that injury rates for both Indigenous people and the total B.C. population went down during that period -- and they went down faster for Indigenous people," said Anne George, an associate professor in pediatrics and in the school of population and public health at UBC. "However, we were concerned about the continued gap between populations. We had to pick apart the data to try to find out why it wasn't closing completely."
Transport injuries not only cause human suffering, but also have financial costs for the province--an estimated $658 million in 2010.
Researchers combined billing data from B.C.'s universal health insurance plan with long-form census data to see how factors such as geography, socioeconomic prosperity (income, education, employment, housing), and ethnicity related to transport injury trends.
In general, living outside the Census Metropolitan Areas of Vancouver and Victoria meant a greater risk of injury, regardless of ethnicity. The injury rate for those outside the metropolitan areas was 43-per-cent higher than it was for the total population.
Indigenous people living off reserves faced a significantly lower risk of injury than those living on reserves. The rate for those living off reserve was 1.77 times that of the total population. For those on reserves, it was 2.0.
It costs money to buy safe cars and keep them in good working order, so the study tried to determine whether injury rates went down where indicators of prosperity went up. Areas with a higher proportion of high school graduates, for example, saw lower injury rates. But other indicators showed mixed results. Areas with higher employment saw lower injury rates among Indigenous people, but higher injury rates among the total population. The researchers suggest that under some conditions, more commuting to work and business-related travel in cars could counteract the socioeconomic benefits of employment.
A trend toward urbanization and greater prosperity during the study period, combined with specific policies such as graduated licensing and booster seat requirements, improved transport safety for all and helped reduce the gap between Indigenous and non-Indigenous British Columbians. This gap could be further narrowed by addressing underlying socioeconomic disparities and systemic racism, say the authors, and through transport injury prevention programs developed by and for Indigenous communities.
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Anne George led the research team. She is an associate professor emerita in UBC's department of pediatrics, an associate faculty member at the school of population and public health, and an investigator emerita with the B.C. Children's Hospital Research Institute.
Mariana Brussoni was the lead author. She is an associate professor in UBC's department of pediatrics and school of population and public health, and an investigator for the B.C. Children's Hospital Research Institute and B.C. Injury Research and Prevention Unit.
Journal
PLoS ONE