# Injury incidence, determinants, and associated burden among children aged 0–17 years: a cross-sectional study in Henan Province, Central China

## TL;DR

This study examines injury rates and risk factors among children in Henan Province, China, highlighting the need for targeted prevention strategies.

## Contribution

The study provides detailed provincial-level data on childhood injury epidemiology and determinants in Henan, China.

## Key findings

- Boys had a significantly higher injury incidence rate (8.23%) compared to girls (5.32%).
- Falls were the leading cause of injury, and home was the most common injury location.
- Children cared for by grandparents had a higher injury risk compared to those cared for by their mothers.

## Abstract

Childhood injury is a major public health issue in China, yet detailed provincial-level data are limited. This study aimed to investigate the epidemiology, determinants, and burden of injuries among children aged 0–17 years in Henan Province.

A population-based cross-sectional survey was conducted from June 2022 to May 2023 using a multi-stage stratified cluster random sampling design. Data were collected via face-to-face questionnaires from guardians of 9,859 children aged 0–17 years. Complex sampling weights were applied, and Rao-Scott χ2 tests and logistic regression were used for analysis.

The overall injury incidence rate was 6.88%, with a significantly higher rate in boys (8.23%) than in girls (5.32%). Multivariable logistic regression indicated that boys had higher odds of injury compared to girls (OR = 1.58, 95% CI: 1.27–1.97), and day students (returning home daily) had higher odds compared to children not enrolled in school (OR = 1.69, 95% CI: 1.16–2.46). Children under the care of their grandparents (OR = 1.33, 95%CI: 1.06–1.67) had a higher injury risk compared to those cared for by their mother. Critically, although a caregiver was present at the time of injury in 54.17% of incidents, effective supervision was lacking in 67.71% of these cases. Falls were the leading cause (53.90% of all incidents) of injury. The home was the most common injury location (41.73%), and leisure activities were the most frequent circumstance (59.30%). The most common injury type was contusion/abrasion (37.47%); the lower extremities were the most frequently injured body site (37.70%). The mean hospital stay was 18 days, with an average of 9 missed days, and the mean cost per injury was 2,713 Chinese Yuan, with road traffic injuries incurring the highest costs.

This study provides key evidence for childhood injury prevention in Henan Province. Priorities include strengthening supervision (especially at home during leisure), tailored interventions for high-risk groups (boys, day students, grandparent-care children), and focusing on falls (high frequency) and road traffic injuries (high cost). Implementing these strategies is essential to reduce the burden of preventable childhood injuries.