Trauma and deprivation in Quebec

Studies show a relationship between social inequality and intentional and unintentional trauma (Marmot et al., 1999; Leclerc et al., 2000). This relationship is poorly understood in Quebec, however, since data on trauma is derived primarily from administrative files (for death and hospitalization), which contain no information on the socioeconomic status of trauma victims.

The recent development of a deprivation index that can be used with these files enables us to at least partially fill this information gap (Pampalon et al., 2000). In this brief paper, we seek to determine whether material and social deprivation is associated with death and hospitalization due to intentional and unintentional trauma in Quebec.

In Quebec, material and social deprivation are strongly associated with trauma. While UT (mostly road traffic accidents) is affected by material deprivation, IT (suicide and homicide) is affected in equal measure by the social and material components. Social deprivation does not appear to be a factor in explaining trauma such as road traffic inju-ries, falls, poisonings, and drownings.

In the case of IT, the risk of hospitalization associated with each of the two forms of dep-rivation doubles between the most privileged and most deprived populations. The risk climbs as high as 4:1 when the two components are combined, a calculation made pos-sible by their relative statistical independence.

These findings show the importance of both economic conditions and social network in cases of suicide and homicide. An epidemiological study of suicide conducted in London, UK, using similar tools, also found that material deprivation and social isolation were major explanatory factors (Congdon et al. 1999).

In conclusion, any trauma intervention programs should clearly take deprivation into ac-count, in both its material and social forms.

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