”Faces of inequality” : The role of social determinants of health in interpersonal violence-related facial fractures – a case-control study
Haapanen, Aleksi (2025)
2025
Master's Programme in Public and Global Health
Yhteiskuntatieteiden tiedekunta - Faculty of Social Sciences
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Hyväksymispäivämäärä
2025-09-15
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:tuni-202509159254
https://urn.fi/URN:NBN:fi:tuni-202509159254
Tiivistelmä
BACKGROUND
Violence is a leading cause of death among adolescents and young adults in many parts of the world and it can cause significant long term sequalae. In particular interpersonal violence (IPV) is an important cause for facial fractures and there are many known factors that are associated with these types of fractures such as the use of alcohol and drugs.
METHODS
This retrospective case-control study utilised data of patients with emergency visits in oral and maxillofacial emergency unit due to a facial fracture caused by IPV from 2013 to 2020 in Helsinki University Hospital. The data was combined with a data from Statistics Finland and for each study subject, controls were randomly selected from the population of the same area as the cases to analyse the association between socioeconomic factors and their association with facial fractures caused by IPV.
RESULTS
Of the patients 88.1% were male, which was significantly more than in the control group (48.9%, p<.0001). There were significant differences between the study group and the control group in education status, socioeconomic status and income status. The fracture patients were more often than the controls of the lowest level of education (OR 3.1, 95% CI 2.67-3.51, p<.0001), of lowest income quartile (OR 3.5, 95% CI 2.98-4.00) and unemployed (OR 5.0, CI 4.24-5.93, p<.0001).
CONCLUSIONS
Facial fractures caused by IPV we associated with among others lower income and education. Multidisciplinary approach would be needed to understand the effects of the injuries on these people with pre-existing economic hardship.
Violence is a leading cause of death among adolescents and young adults in many parts of the world and it can cause significant long term sequalae. In particular interpersonal violence (IPV) is an important cause for facial fractures and there are many known factors that are associated with these types of fractures such as the use of alcohol and drugs.
METHODS
This retrospective case-control study utilised data of patients with emergency visits in oral and maxillofacial emergency unit due to a facial fracture caused by IPV from 2013 to 2020 in Helsinki University Hospital. The data was combined with a data from Statistics Finland and for each study subject, controls were randomly selected from the population of the same area as the cases to analyse the association between socioeconomic factors and their association with facial fractures caused by IPV.
RESULTS
Of the patients 88.1% were male, which was significantly more than in the control group (48.9%, p<.0001). There were significant differences between the study group and the control group in education status, socioeconomic status and income status. The fracture patients were more often than the controls of the lowest level of education (OR 3.1, 95% CI 2.67-3.51, p<.0001), of lowest income quartile (OR 3.5, 95% CI 2.98-4.00) and unemployed (OR 5.0, CI 4.24-5.93, p<.0001).
CONCLUSIONS
Facial fractures caused by IPV we associated with among others lower income and education. Multidisciplinary approach would be needed to understand the effects of the injuries on these people with pre-existing economic hardship.