7. Injury-related inequalities

Injuries such as falls, poisoning and burns often occur in the private home, but they are not settingspecific as they can also occur during sport and recreation or other activities. For many injuries the relative contribution of the environment is unclear: it can be the single cause (as with poisoning caused by lack of adequate cooling or storage of food items) or a contributor (as with a fall on a staircase), but it can also have no causal impact (as with intentional poisoning or sports injuries). The risk of injury therefore often depends on a combination of personal factors (such as age, sex, physical capacity and level of risk awareness) and environmental context factors (such as conditions and safety features of built environments, consumer products and technical and electrical equipment).

No environment is free from risks but the most vulnerable populations groups, who have lower coping capacity, are often exposed to settings with higher levels of injury risk (such as inadequate housing); this is for example the case for children and elderly people and those with functional limitations. These population groups may suffer from a higher likelihood of injury, and may also be especially vulnerable to the consequences of such injuries and affected by more severe health outcomes. Social disadvantage is often associated with poorly maintained physical environments and reduced coping capacities, indicating that injuries may not only be affected by demographic aspects but also be distributed unequally across socioeconomic strata. As injury monitoring systems have traditionally focused on the demographic characteristics (age and sex) of injury victims, however, this section centres on injury-related inequalities by sex and age in the WHO European Region for two indicators:

• inequalities in fatal poisoning • inequalities in fatal falls.

These cover most of the countries in the WHO European Region, but the data provide very little insight into socioeconomic inequalities in injuries and related deaths.

Transport-related injuries and injuries related to work settings are addressed in the sections on urban environment and transport inequalities (Chapter 5) and on work-related inequalities (Chapter 6).