SOCIAL AND ECONOMIC INEQUITIES IN THE IMPACT OF A PLAYGROUND SAFETY REGULATION ON PEDIATRIC CONCUSSIONS IN ONTARIO
Author(s)
Matthew Sudiyono, MSc.
Kinesiology & Health Sciences, York University, Toronto, ON, Canada.
Kinesiology & Health Sciences, York University, Toronto, ON, Canada.
OBJECTIVES: (1): To evaluate changes in emergency department (ED) visits for playground concussions surrounding the 2016 enactment of the Child Care and Early Years Act, Ontario safety regulation O. Reg. 126/16 s.18(2)(2): To asses whether these changes differed by Material Deprivation Index quintiles, a neighbourhood-level socioeconomic status.
METHODS: Ontario ED data from the National Ambulatory Care Reporting System were analyzed for children aged 0-19 between 2014 and 2024. Concussions due to falls and being struck by an object on playgrounds were included and stratified by year and by Material Deprivation quintiles. An interrupted time series analysis was conducted to examine changes from 2014-2016 (baseline), 2017-2019 (post-regulation), 2020-2021 (COVID-19 closures), and 2022-2024 (years after playgrounds reopened).
RESULTS: 14,441 cases of playground concussions were analyzed. Across all quintiles, there were insignificant changes in average counts of ED visits due to fall-related concussions in the 2017-2019 (16.00 ± 21.05, p = 0.47) and the 2022-2024 (-28.67 ± 21.05, p = 0.22) time periods, respectively, relative to baseline. However, during the 2022-2024 time period, those from the least deprived neighborhoods (Q1) had 23.00 ± 6.80 (p = 0.01) fewer cases while the most deprived quintile (Q5) only saw 12.67 ± 4.84 (p = 0.03) fewer cases of fall-related concussions post-regulation. No significant changes in ED counts were observed in strike-related concussions on playgrounds.
CONCLUSIONS: Following an Ontario safety regulation, modest declines in concussion cases were observed primarily among children playing in less deprived neighbourhoods, while those in more deprived areas experienced smaller or negligible improvements.
METHODS: Ontario ED data from the National Ambulatory Care Reporting System were analyzed for children aged 0-19 between 2014 and 2024. Concussions due to falls and being struck by an object on playgrounds were included and stratified by year and by Material Deprivation quintiles. An interrupted time series analysis was conducted to examine changes from 2014-2016 (baseline), 2017-2019 (post-regulation), 2020-2021 (COVID-19 closures), and 2022-2024 (years after playgrounds reopened).
RESULTS: 14,441 cases of playground concussions were analyzed. Across all quintiles, there were insignificant changes in average counts of ED visits due to fall-related concussions in the 2017-2019 (16.00 ± 21.05, p = 0.47) and the 2022-2024 (-28.67 ± 21.05, p = 0.22) time periods, respectively, relative to baseline. However, during the 2022-2024 time period, those from the least deprived neighborhoods (Q1) had 23.00 ± 6.80 (p = 0.01) fewer cases while the most deprived quintile (Q5) only saw 12.67 ± 4.84 (p = 0.03) fewer cases of fall-related concussions post-regulation. No significant changes in ED counts were observed in strike-related concussions on playgrounds.
CONCLUSIONS: Following an Ontario safety regulation, modest declines in concussion cases were observed primarily among children playing in less deprived neighbourhoods, while those in more deprived areas experienced smaller or negligible improvements.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH226
Topic
Epidemiology & Public Health, Health Policy & Regulatory
Topic Subcategory
Public Health
Disease
Injury & Trauma