Less advantaged children are 17 times more at risk of unintentional or violent death than more advantaged peers

BMJ 2010; 341 doi: (Published 25 November 2010) Cite this as: BMJ 2010;341:c6795
  1. Helen Mooney
  1. 1London

Children aged under 1 year from poorer families are 17 times more likely to die from an unintentional injury than those born to parents in professional roles, according to figures from the Office for National Statistics (ONS).

The figure shows a glaring discrepancy in the rate of unintentional death between children whose parents are either in a manual occupation or out of work and those whose parents have a higher managerial or professional job.

According to the ONS findings, parents who are out of work or who have never worked are also around 12 times more likely to lose a child aged under 15 years from an intentional assault than parents in the most advantaged classes.

The ONS report is based on evidence of the cause of death for almost 1200 children aged between 28 days and 15 years and highlights the link between social inequalities and the risk of fatal incidents and intentional assaults.

The figures also show that the widest differences between the children of parents in professional and managerial jobs and those of parents in manual occupations were in deaths caused by fires and pedestrian incidents, followed by unintentional suffocation.

Myer Glickman, ONS head of health analysis, said: “The study shows that children in the most disadvantaged families . . . have a risk of accidental or violent death around five times that of children with at least one parent in a professional or managerial job. The difference between classes in child death rates is more than 15 times for deaths from fires and more than eight times for fatal pedestrian accidents.”

The findings correspond with evidence that has shown a link between childhood hospital admissions after assault and deprived areas.

During 2001-3 there were 228 deaths of children in pedestrian incidents and 307 in other road crashes. Other important causes of fatal incidents were suffocation in babies and fire and drowning in children under 5 years. There were 164 deaths of children where assault was given as the cause of death, with some cases reported as still pending investigation.

The report is published in the same week as new guidance from the National Institute for Health and Clinical Excellence which recommends that the highways authority, fire and rescue services, housing and children’s services need to work together more effectively to reduce child injuries and deaths.

Sheila Merrill home safety manager for the Royal Society for the Prevention of Accidents told the BMJ that although the findings were “pretty shocking” they did not come as a surprise.

“We have been working very hard in recent years to tackle the effects of social inequalities, knowing that people living in the most deprived areas are often the most at risk of being hurt or worse in an accident.”

A Department for Education spokesman said: “Keeping children safe is a top priority across government and reducing unintentional injuries is key to this. We know that the burden of serious injuries falls unequally on those from low income families. That is why we are committed to reducing those inequalities, and we will look to support local authorities and their partners in preventing injuries amongst all children and families in their area.

“The secretary of state has asked Professor Munro to conduct a review of the child protection system, with a focus on strengthening the social work profession, freeing them from unnecessary bureaucracy and regulation.”


Cite this as: BMJ 2101;341:c6795


  • See BMJ 2010;341:c6755; doi=10.1136/bmj.c6755

  • Social Inequalities in Fatal Childhood Accidents and Assaults: England and Wales, 2001-03 is published in Health Statistics Quarterly No 48 at

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