Unintentional childhood mortality during emergencies in Israel: a comparative study

Inj Prev. 2024 Aug 23:ip-2023-045229. doi: 10.1136/ip-2023-045229. Online ahead of print.

Abstract

Background: Armed conflicts are likely to have implications for the welfare and safety of children, potentially leading to increased rates of unintentional childhood injuries.

Methods: We examine data from Israel concerning the relationship between emergencies and childhood mortality due to unintentional injuries using the media-based database of Beterem Safe Kids Israel to analyse seven events: 2008 Gaza War, 2014 Gaza War, first COVID-19 Lockdown, second COVID-19 Lockdown (September 2020), third COVID-19 Lockdown (December 2020), 2021 Israel-Palestine crisis and 2023 Israel-Gaza War. These events are categorised into Emergency Periods (EPs) and Emergency Routine Periods (periods during which an emergency extends and normalises into a stable routine; ERPs). For each EP we selected a comparable Routine Period (RP).

Results: Unintentional childhood mortality rates are lower during EPs, compared with RPs. Conversely, there is an increase in unintentional mortality rates during ERPs. EPs and ERPs occurring during armed conflicts exhibit higher unintentional mortality rates compared with health-related EPs and ERPs. Furthermore, military-related ERPs show higher unintentional mortality rates compared with the corresponding RPs. Unintentional mortality rates are notably higher among Arab children compared with Jewish children, particularly during ERPs. Unintentional childhood mortality also differs as a function of socioeconomic ranking, with widening gaps between municipalities of low socioeconomic ranking and municipalities of medium to high socioeconomic ranking, during EPs and ERPs.

Conclusions: We hypothesise that parents' emotional availability declines during EPs and ERPs associated with military conflicts, coinciding with socioeconomic aspects, impacting families' well-being and children's safety.

Keywords: COVID-19; Mortality; Safe Community; Socioeconomic Status; War/Conflict.