Determinants and psychological outcomes of unintentional injuries in childhood

Abstract

Background
Unintentional injuries in childhood are a persistent and preventable public health challenge, and the determinants have been widely reported. However, there is a paucity of research into how these differ across social groups. Further, the long-term psychological consequences of injury are poorly understood, with few studies investigating this link beyond the acute post-injury stage.

Aims
To elucidate the determinants of unintentional injuries in children aged five years and under in the UK and to examine the relationship between unintentional injuries in childhood and mental health in adolescence.

Method
I conducted a systematic review of observational studies investigating determinants of unintentional injury in children aged 0-5. I used this study to inform the following four empirical chapters wherein I used the Millennium Cohort Study to investigate the determinants of unintentional injury by age five, the role of housing in injury, and the relationship between ethnicity and migration and injury. I further investigated the relationship between unintentional injury during the childhood years and mental health in adolescence.

Results
The risk profile of recurrent injuries differed qualitatively from fewer or no injuries and that there were notable sex differences in risk profiles. Moreover, housing quality was associated with multiple injuries but did not statistically explain the relationship between social housing and injury. The relationship between housing quality and injury was only evident for those in owner-occupied housing in stratified analyses. I found that for Pakistani and Bangladeshi children, the relationship between ethnicity and lower risk of injury was almost completely explained by having a mother born outside the UK. Whereas for Black African children, the relationship between ethnicity and injury was not explained by migrant status. Finally, I found that multiple injuries and not severe injuries were associated with injury and multiple injuries in childhood were associated with poor mental health but only for girls.

Conclusion
The thesis makes several key contributions to the literature. It demonstrates the multifactorial nature of childhood injury risk and its long-term consequences. It demonstrates variations in risk profiles by sex and ethnicity. Additionally, it provides preliminary evidence that cumulative injury experiences in childhood may have implications for adolescent mental health, particularly for girls.

Date of Award	Jan 2026
Original language	English
Supervisor	Emma Curran (Supervisor), Gerard Leavey (Supervisor) & Michael Rosato (Supervisor)