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Child Injury in the Preschool Years

Injuries are a leading cause of child hospitalisation and death in Aotearoa New Zealand. On average, 2,600 children under five are admitted to hospital with an injury annually, and close to 50 die. Understanding the factors that place children at increased risk of injury will potentially reduce the burden of childhood injury.

This study used Growing Up in New Zealand (GUiNZ) data to build a comprehensive picture of the environments that contribute to injuries among NZ pre-schoolers. Data from 6,114 children in the GUiNZ cohort were analysed to explore injury rates and the environments associated with increased risk of injury. The study focussed on parental reports of injuries among preschool aged children.


  • From birth to 4½ years of age, 48% of children experienced at least one injury that required medical attention. Being in the ‘high injury risk’ group (1-3 injuries with a hospitalisation, or ≥4 injuries; 8% of children) compared with being in a combined no injury or low injury risk group (92%) was the key outcome for the study.
  • Child factors associated with being in the ‘high injury risk’ group were those commonly associated with a highly ‘surgent’ temperament. i.e being highly active, intensely pleasure seeking, and impulsive.
  • Factors significantly associated with an increased likelihood of a child being in the ‘high injury risk’ group included living in a high-needs environment; having a high rate of household risk factors; having a high rate of family risk factors; and living in high stress households.
  • Children in high nurturing environments were less likely to be in the high injury risk group than those in lower nurturing environments.
  • No associations were found between any one home safety feature or a combination of features (i.e., working smoke alarms, driveway, pool and boundary fencing, safe power outlets, safe hot water temperature, securely stored poisons) and injury outcome, after other child, social and physical environment variables were considered.

The research suggests that a combination of child, demographic, socioeconomic, health and social factors appears to increase the likelihood of high injury risk among preschool aged children in this study.

The researchers say their findings reinforce the multifactorial nature of injury risk to pre-schoolers and highlights the need for a collaborative multisector (public, government, and private sector) approach to prevent or reduce injury risk and help us identify children who may be at higher risk of injury.

In addition to direct safety interventions, policies to reduce poverty and inequalities in socioeconomic status may impact injury risk.

For enquiries about this research please email

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