Injury Hospitalizations

Sex and Gender-based Analysis of this topic

Definition
The injury hospitalization rate refers to the rate of acute care hospitalization due to injury (excluding poisoning and other non-traumatic injuries) per 100,000 population [1]. Injury hospitalization can result from a variety causes including: motor vehicle accidents, falls, unintentional and self-inflicted injuries, assault, cuts, drowning, fire, machinery accidents and natural/environmental causes to name a few [2]. This rate is age-adjusted, a method that eliminates the effect of varying age compositions in different populations so that injury hospitalization rates can be compared between different populations. In 2005, the injury hospitalization rate across Canada was 444 for females, compared to 627 in males [3].
 
 
Sex Issues

The leading cause of injury hospitalizations in Canada (2005-2006) was unintentional falls (57%) [4]. The rate of fall-related injuries in women exceed that of men in all age groups [3, 4, 5]. Due to longer life expectancies and higher rates of osteoporosis, women are at higher risk of injuries (most commonly fractures) due to falls than men [6,7]. For example, the rate of injuries resulting from falls is 8,800 for women, compared with only 5,600 for men [5].

Canadian women are more likely to experience injury hospitalization due to self-inflicted injuries and suicide attempts than men, with 62% of suicide injury hospitalizations being female. Self-inflicted injuries are intentionally committed by a person to her- or himself and exclude unintentional self-harm [8]. In Manitoba, self-inflicted injuries were the second leading cause of injury hospitalization among women after falls. Manitoban women were found to be 1.7 times more likely to be hospitalized for self-inflicted injury than men [9]

 
 
Gender Issues

Generally, males are more likely to experience injury hospitalization which is often due to sporting or athletic injuries, whereas women’s injuries are due to accidents while doing chores at home [10].

Women are disproportionately affected by certain types of violence-related injuries. In Canada, women represent 86% of sexual assault victims and 78% of criminal harassment victims [11]. Injuries resulting from spousal/partner violence occur in 44% of females compared to only 19% in males [12]. In 2004, it was estimated that approximately 8% of women had experienced at least one incident of physical or sexual violence by a current or former partner within five years of the survey [12]. Women who are economically dependent on their partners may be more vulnerable to spousal/partner violence. Women are more likely to be of a lower socioeconomic status than men [13], which according to the World Health Organization, increases the likelihood that women will become victims of violence [14].

 
 
Diversity

The territories have a noticeably higher injury hospitalization rate for both sexes compared to the rest of Canada. For example, the female injury hospitalization rates in the Northwest Territories and Nunavut were 1,241 and 1,011 respectively in 2006, whereas the same rates for Nova Scotia and Ontario were 393 and 371 [3].

The rate of injury due to domestic violence is higher among women aged 15 to 24, Aboriginal women, women living in short-term relationships, and women with partners who drink heavily [12, 14]. Aboriginal women were found to be three times more likely as non-Aboriginal women to report spousal violence (24% versus 7%) [12,15].

Injury hospitalization due to motor vehicle accidents (MVA) in traffic is much higher in adolescent girls (ages 14-19, 20-24) than adult women (25+) [16]. This may be due to higher rates of risk-taking behaviours during adolescence.

Injury is one of the leading causes of deaths in the Aboriginal population and accounts for 26% of all deaths among Aboriginal people, compared to only 6% of deaths within the Canadian population [17]. First Nations girls and women in Manitoba are more than three times more likely to be hospitalized for injury than their Non-First Nation counterparts [8]. While the leading cause of injury for Manitoban Non-First Nation women was falls, major cause for injury hospitalization among First Nations women was self-inflicted injury [8].

 
 
Critique
Women are more at risk for certain types of injuries, such as injuries resulting from violence, self-inflicted injury and falls among senior women. The injury hospitalization rate resulting from domestic violence against women may be under-reported as some women may not present injuries or report domestic violence at hospitals. The overall injury hospitalization rate may also be underestimated as injuries presented at institutions that are not lead trauma facilities are excluded [18].
 
 
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