Inequalities in Injury Risk in U.S. Adults: Socioeconomic Status, Health Behaviors, and Contextual Determinants of Injury Morbidity and Mortality

Injuries have been shown to be an important public health concern as they contribute morbidity, disability, mortality, and costs to individuals and society. Previous research has highlighted the importance of health behaviors, socioeconomic status, and neighborhood characteristics on injury risk, however, few studies have incorporated all of these aspects. The purpose of this dissertation research was to examine individual and contextual level predictors of injury risk in different adult populations by providing a more comprehensive theoretical framework and by incorporating individual socioeconomic factors, health behaviors, and contextual factors into an empirical analysis of injury risk. Specifically, this research sought to investigate 1) socioeconomic and behavioral disparities in injury morbidity in US adults; 2) the influence of contextual characteristics on individual level injury morbidity controlling for individual characteristics in young adults; and 3) the impact of contextual factors on injury mortality in Texas working age adults. Bivariate statistics, logistic regression models, and multilevel logistic regression models were used to examine the data and test hypotheses.

The main findings showed that low socioeconomic status (SES) increased injury risk, but this association varied based on the SES measure used. Further, risky health behaviors increased injury morbidity risk. Lastly, a composite measure of contextual factors was associated with injury risk above and beyond individual level characteristics, indicating that less favorable living conditions exerted a protective effect on injury risk. Future research should investigate alternative ways to measure injuries and conceptually and empirically examine the protective effect of less favorable neighborhood conditions.