Effects of neighbourhood and individual factors on injury risk in the entire Swedish population: a 12-month multilevel follow-up study

In this cumulative incidence study of the entire population of Sweden, we examined the association between neighbourhood income level and injury risks across a comprehensive set of individual variables. The population, stratified by age (0-14, 15-64, and > or =65 years), was followed for incident injury events in 1998. Multilevel logistic regression was used to examine the associations between neighbourhood income level and injury, including deaths from injury. Risks were analyzed, taking individual demographic and socioeconomic variables and alcohol/substance abuse into account. Falls were the most frequent non-fatal injuries in all age groups. People (0-14 years and 15-64 years) in the most deprived neighbourhoods exhibited higher odds of injuries (OR = 1.15; CI = 1.08-1.22 and OR = 1.34; CI = 1.26-1.43, respectively) than those in the same age groups in the most affluent neighbourhoods (OR = 1). In the full model, injury odds ratios decreased but remained significant in people 0-14 years. The large between-neighbourhood variance in all age groups indicated variation between neighbourhoods in injury incidence. Our results suggest that interventions focused on contextual aspects of neighbourhoods, in addition to individual behaviours, may have a positive impact on injury prevention.