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Refugee children and youth at higher risk of unintentional injury compared with non-refugee immigrants


Refugee children and youth have a 20 per cent higher rate of unintentional injury compared to their non-refugee immigrant counterparts, according to a new study by researchers at the Institute for Clinical Evaluative Sciences (ICES) and The Hospital for Sick Children (SickKids).

In the study published today in Injury Prevention, researchers examined data representing children and youth up to 24 years of age from immigrant families living in Ontario from 2011 to 2012 to compare the rates of unintentional injuries in immigrant children and youth by immigration visa class and region of origin.

Unintentional injuries are largely preventable yet continue to be a leading reason for children and youth to seek emergency medical care. Unintentional injuries include, but are not limited to, motor vehicle injuries, poisoning, suffocation, scald burns and machinery-related injuries.

In Ontario, there were 54,273 visits to a hospital for injuries each year by non-refugee immigrants and 12,141 of such visits by refugees. This amounts to 6,596 and 8,122 emergency room visits per 100,000 non-refugees and refugees, respectively. Hospitalization rates were also lower among non-refugees compared with refugees (145 hospitalizations per 100,000 population non-refugees versus 185 hospitalizations per 100,000 refugees)

“The results of our study highlight the need to engage with refugee families shortly after arrival in order to encourage injury prevention in this population,” says author Dr. Natasha Saunders, staff physician in paediatric medicine and associate scientist at SickKids and adjunct scientist at ICES.

There are a variety of contributing factors that may influence injury risk among refugee and immigrant children in Canada including environmental, social and cultural differences. The researchers cite examples such as differing healthcare-seeking behaviours among immigrants, especially for minor injuries; housing safety like functioning smoke alarms in the home or safe storage of toxic substances; and environmental exposures like access to properly-fitted car seats, use of bicycle helmets and access to safe playground spaces. Additionally, varying cultural practices in the family’s home country could also play a role, like sleep practices, cooking customs, supervision of children and time spent in free play.

The study indicates that the rates of injury among young children compared with adolescents both in refugees and non-refugees immigrants are higher than reported rates in the general population of Canadian children and youth. “This supports the notion that some of these social and cultural practices may contribute to injury risk,” says Saunders.  

In high income countries, youth (compared with young children and older adults) are the age group at highest risk of injury and most in need of targeted injury prevention strategies. A considerable number of research programs that explore youth injury typically include those from 10 to 24 years (including routine reporting by the World Health Organization and the US Centers for Disease Control). While there is no international consensus on age boundaries for youth, this study is consistent with the definition used by the United Nations (15 to 24 years), the researchers say.

This study was supported by the Canadian Institutes for Health Research, SickKids Foundation and the Institute for Clinical Evaluative Sciences (ICES), which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). It is an example of how SickKids and ICES are contributing to making Ontario Healthier, Wealthier and Smarter

“Unintentional injuries among refugee and immigrant children and youth in Ontario, Canada: a population-based cross-sectional study,” was published today in Injury Prevention.

Author block: Natasha Saunders, Alison Macpherson, Jun Guan and Astrid Guttmann.

The Institute for Clinical Evaluative Sciences (ICES) is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy. For the latest ICES news, follow us on Twitter: @ICESOntario

The Hospital for Sick Children (SickKids) is recognized as one of the world’s foremost paediatric health-care institutions and is Canada’s leading centre dedicated to advancing children’s health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada’s most research-intensive hospitals and has generated discoveries that have helped children globally. Its mission is to provide the best in complex and specialized child and family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures health-care professionals; and champion an accessible, comprehensive and sustainable child health system. SickKids is proud of its vision for Healthier Children. A Better World. For more information, please visit www.sickkids.ca. Follow us on Twitter (@SickKidsNews) and Instagram (@SickKidsToronto).


Deborah Creatura
Media Advisor, ICES
[email protected]
(o) 416-480-4780 or (c) 647-406-5996

Suzanne Gold
The Hospital for Sick Children (SickKids)
[email protected]
416-813-7654 ext 202059


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