Child safety is an important aspect of the early years agenda and affects the whole of the workforce. It is now recognised that unintentional injury is one of the main causes of childhood death and is the most common cause of emergency hospital admissions in children under 15 years of age, thereby contributing significantly to quality of life and outcomes for children.
Child safety and inequalities in the early years
Rates of hospital admission and deaths resulting from unintentional injuries are highest among Scotland's most deprived children.
A range of interventions can increase awareness of dangers and improve child safety.
Quick links:
- What are health inequalities?
- Policy context
- How do inequalities relate to unintentional injuries in children?
- Preventing unintentional injuries in the home
- Barriers to preventing injury in the home
- Effective interventions to reduce unintentional injuries
- Providing information and support to parents
- Child protection, abuse and neglect
What are health inequalities?
The World Health Organisation defines health inequalities as "differences in health status or in the distribution of health determinants between different population groups."
For a fuller discussion, please see Inequalities in the early years.
Policy context
Activity in this area is consistent with commitments and priorities detailed in the Early Years Framework and the National Parenting Strategy, Equally Well, Achieving our Potential, the Curriculum for Excellence, a range of NHS Scotland's Quality Indicators and is relevant to Scotland's national practice model for child-centred services - Getting it Right for Every Child (all external links).
The United Nations Convention on the Rights of the Child enshrines the right of children to be protected from injury and negligent treatment (Article 19) and requires signatory states to ensure children and parents are educated in child health and prevention of accidents (Article 24).
The Scottish Government has also set 15 national outcomes including:
- Our children have the best start in life and are ready to succeed
- We have improved the life chances for children, young people and families at risk
- We live our lives free from crime, disorder and danger
For more information on evidence-based health improvement and the work of NHS Health Scotland, see: A Fairer Healthier Scotland (external link).
How do inequalities relate to unintentional injuries in children?
Unintentional injuries are one of the leading causes of death and disability in young children. They can occur in the home, at school, on the road and during play and recreation. Children under 5 years of age are most at risk from injuries in the home than in other areas.
As children grow and develop they are exposed to a range of hazards that may increase the risk of experiencing an unintentional injury.
While the pattern of risk factors associated with unintentional injury in children is dependent upon the setting in which injury occurs and the type of injury, the risk of unintentional injuries increases with age (more liekly in younger children), gender (more likely in boys) and low socio-economic status / socio-economic deprivation.
(ISD Scotland - Unintentional Injuries Report 2010 (external link); Evidence Summary: Public health interventions to prevent unintentional injuries among the under 15s (PDF Download - 589KB)).
Preventing unintentional injuries in the home
Given children’s vulnerability to environmental hazards, it is important to minimise their exposure to these in their home, surrounding neighbourhoods, nurseries and child care facilities.
Children under five years are more likely to experience injuries in the home (e.g. falls, burns and scalds, and poisoning) than in other locations.
Barriers to preventing injury in the home
- Faulty or poor equipment.
- The cost of installing and maintaining equipment.
- Living in accommodation that cannot be modified (e.g. rented accommodation).
- A lack of professional knowledge about policy or home safety support services.
- Policy and legal barriers, e.g. the poor enforcement of legislation.
Effective interventions to reduce unintentional injuries
Efforts to prevent unintentional injuries should balance the potential risks against the benefits that children experience, particularly in outdoor play and leisure activities.
Those delivering interventions should always be mindful of situations where mothers (or other primary carers) lack the autonomy to make major household changes or decisions about household purchases.
These include:
- The provision of home safety advice.
- Free or discounted appropriate safety equipment that is supplied and fitted (e.g. smoke alarms, safety gates) to families at high risk of unintentional injury.
- Education and information about general child development.
Factors that enable effective injury prevention programmes in the home include:
- Strong policy drivers and legislation (e.g. around child resistant containers).
- Partnership and collaboration between service providers in low-income communities.
- An understanding of the reasons behind a family’s failure to comply (e.g. living in a home that they are not free to modify).
- Promoting and encouraging the safeguarding role of mothers.
Evidence Summary: Public health interventions to prevent unintentional injuries among the under 15s (PDF Download - 589KB), Early Years Effective Interventions Paper (external link)).
Providing information and support to parents
The 2012 Health Scotland paper, Exploration of the information support needs of parents(external link), was the result of in-depth work with 132 parents from across Scotland.
It found that parents preferred 'personal, empathetic support from individuals in dealing with their specific needs for information and support on child health and parenting'.
Three overarching themes emerged:
- Parent information/support is undermined when parents feel marginalised
- ‘Trust’ shapes how information is sought, received and used
- Parents respond most positively to personalised information and support.
Among its recommendations, the report emphasises the need for:
- continuing professional development for staff to enable them to present more personalised information and support
- alternative formats, products and services that more fully take account of the needs, views and preferences of young mothers, fathers and parents with literacy issues
- increased opportunities for face-to-face peer support and virtual social networks.
A Pathway of Care for Vulnerable Families (0-3) (external link) sets out key contact points and interactions for those working with vulnerable families of younger children.
Child protection, abuse and neglect
This section deals with unintentional injury.
For information on abuse and neglect, please see our section on Abuse, neglect and gender-based violence.
