The effect of socio-economic status on non-fatal outcome after injury: A systematic review

Injury. 2017 Mar;48(3):578-590. doi: 10.1016/j.injury.2017.01.013. Epub 2017 Jan 5.

Abstract

Background: Over the past decades, the number of survivors of injuries has rapidly grown. It has become important to focus more on the determinants of non-fatal outcome. Although socio-economic status (SES) is considered to be a fundamental determinant of health in general, the role of SES as a determinant of non-fatal outcome after injury is largely unknown.

Methods: An online search was conducted in November 2015 using Embase, Medline, Web of Science, Cinahl, Cochrane, Google scholar and PubMed. Studies examining the relation between SES and a physical or psychological outcome measure, or using SES as a confounder in a general trauma population were included. There were no restrictions regarding study design. The 'Quality in Prognostic Studies tool' was used to assess the methodological quality of the included studies.

Results: The 24 included studies showed large variations in methodological quality. The number of participants ranged from 56 to 4639, and assessments of the measures ranged from immediately to 6year post-injury. Studies used a large number of variables as indicators of SES. Participant's educational level was used most frequently. The majority of the studies used a multivariable technique to analyse the relation between SES and non-fatal outcome after injury. All studies found a positive association (80% of studies significant, n=19) between increased SES and better non-fatal outcome after injury.

Conclusion: Although an adequate and valid measure of SES is lacking, the results of this review showed that SES is an important determinant of non-fatal outcome after injury. Future research should focus on the definition and measurement of SES and should further underpin the effect of SES on non-fatal outcome after injury.

Keywords: Determinant; Injury; Non-fatal outcome; Physical outcome; Physiological outcome; Socio-economic status; Socioeconomic status; Trauma.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Health Surveys
  • Hospitalization / statistics & numerical data*
  • Humans
  • Netherlands / epidemiology
  • Outcome Assessment, Health Care
  • Residence Characteristics
  • Socioeconomic Factors*
  • Wounds and Injuries / epidemiology*
  • Wounds and Injuries / physiopathology