Preventing Unintentional Injuries

Child injuries are a major public health issue worldwide. For all categories of unintentional injury, boys die more often than girls, with the exception of fire-related burns. In Canada, among children and youth aged 1 to 19 years injury is the leading cause of death.

The burden of injury among immigrant children and youth

A 2017 Ontario population-based study found rates of unintentional injury were lower among immigrant youth compared with Canadian-born youth. The reasons for this are not clear, and sociodemographic factors that predict injury risk in the general population did not apply to all immigrant sub-groups. The authors suggest that differences in risk-taking and care-seeking behaviours could play a role.

Injury and social determinants of health

Certain conditions can make children more susceptible to injury, including their age or stage of development, gender, and particularly poverty and environment.Studies have shown that a higher risk of burn injury is associated with low economic status and living in stressful circumstances. Recent immigrants are more likely to be among the working poor than native-born Canadians.

Other factors that can increase a child’s risk of injury include:

• Cultural background
• Maternal age and education
• Economic status
• Housing conditions
• Overcrowding
• Lack of supervision
• Inadequate safety precautions
• Unfamiliarity with Canadian climate
• Unawareness of Canadian safety laws and benefits (e.g., booster seats)

Despite the clear association between socioeconomic factors and risks of childhood injury, targeted prevention measures for economically disadvantaged children are still lacking.

Causes of injury among newcomer children and youth

Although the causes of injury in young newcomers to Canada are not well-documented, global and Canadian data provide some insight. Worldwide, the leading causes of injury-related death among children and adolescent are road traffic injuries, drowning, burns, falls and poisoning.

Source: Canadian Paediatric Society. Children and youth injury prevention in Canada: Preventing harm, protecting futures. Ottawa (ON); May 2026.

Source: Canadian Paediatric Society. Children and youth injury prevention in Canada: Preventing harm, protecting futures. Ottawa (ON); May 2026.

Clinical vignette: A preventable injury

A new immigrant mother of 5 children had to work evenings. She left her oldest child, an 11-year-old girl, to care for 4 younger siblings. While this daughter was preparing dinner over a small BBQ in the kitchen, the 2-year-old pulled a pot of hot soup off the countertop, which spilled over her and caused a severe scald burn.

Learning points

• Helping the newcomer family to find community support, money and age-appropriate babysitters might have prevented this injury.
• Scald burns frequently occur in the kitchen, when children spill a hot substance, or in the bathroom, when water from the faucet is too hot.
• Physicians should ask newcomer families about, and counsel against, the following hazards:
  • fire and burns from the use of auxiliary heating units due to inadequate home heating;
  • carbon monoxide poisoning from using charcoal briquettes indoors;
  • scald burns from excessively high water heater settings (the recommended maximum household temperature is 49°C [120°F]).
  • burns from hot beverages; lids must be used at all times, and hot drinks should be kept out of children’s reach; and
  • injuries from children being present in the kitchen during meal preparation; young children should be kept away from areas near the stove and microwave.

What health professionals can do

  ⇨ Include injury prevention in your practice

To help prevent injury among young Canadians, health professionals need to know what factors put children at greater risk and what protective strategies keep them safer.

The Canadian Paediatric Society (CPS) recommends that health professionals include injury prevention messages in their practice. Advising newcomers of preventive measures is especially important because they may not be aware of Canadian safety regulations, practices or the benefits of following them. Regulations, products, environments, and attitudes may differ from those in their country of origin. For example, it is important to emphasize that car and booster seats are required by law almost everywhere in Canada (though there may be variations among the laws).

Practitioners should advise immigrant and refugee families of the importance of preventive measures, such as:

• Using appropriate car seats, child restraints and seat belts when driving.
• Wearing motorcycle and bicycle helmets.
• Wearing personal flotation devices.
• Home safety measures (e.g., fire alarms, extinguishers, and safe storage of toxic substances).

Guidance for specific injury prevention counselling for the paediatric population is available in the following records:

• The Rourke Baby Record, for the first 5 years
• The Greig Record, for 6 to 17 years

Many newcomers would prefer to receive culturally sensitive prevention instructions in their native language, in small groups through established community agencies. Prenatal and community health classes should be encouraged to include injury prevention topics.

  ⇨ Provide handouts for parents and caregivers

• Parachute Canada: Parent resources on injury prevention, including car and home safety.
• Child Safety Link: Multilingual handouts on correct use of car and booster seats.
• Canadian Paediatric Society: Information sheets for parents on car seat safety, helmet use in sport, water safety and other topics.
• Refugee 613: Infographic and videos on water safety in various languages.
• Health Canada: Home safety
• Health Canada: Safe sleep for your baby

  ⇨ Understand specific challenges for newcomers

Clinicians need to be aware of the specific challenges newcomers may face when trying to act on injury prevention advice. For example:

• Living in rental accommodations or sharing a home with extended family, which may make modifications for safety reasons difficult or impossible.
• Limited access to safe play or community spaces outside.
• The cost of installing safety equipment or making repairs (e.g., installing smoke alarms).
• Social isolation and a lack of family or friends to help with child care.
• Differences in child safety norms in their new country compared with the country of origin.
• Mistrust of officials and concern about accusations of neglect, which may prevent parents from asking about injury prevention or seeking medical help for an unintentionally injured child.
• Language barriers.

  ⇨ Adopt a multi-tiered approach to injury prevention

The most effective strategy for injury prevention is one that includes facets of public health, such as improving and enforcing legislation, better engineering and education.

Numerous data support the need for a national, multi-tiered approach to injury prevention in Canada:

• One 2019 Canadian Health Survey on children and youth found that head injuries and concussions were among the commonly reported injuries. They occurred during sports, playing and physical activities.
• Collisions involving off-road vehicles (ORVs) are among the causes of severe injuries in Canadian children and adolescents, who account for 27% to 35% of related fatalities.

The majority of injuries sustained by children and youth are preventable. Countries with the greatest reductions in childhood injury rates and severity have used a combination of approaches to prevention.