The relationship between socioeconomic deprivation and maxillofacial trauma in Midwest Ireland

Aim: The primary objective of this study was to assess the potential association between social deprivation and maxillofacial trauma in Midwest Ireland. Method: A retrospective cohort study of patients undergoing surgical management of maxillofacial fractures, between January 2014 and December 2023, was undertaken. The Pobal 2022 Index utilises recent census data to determine relative deprivation of each electoral region. This database was utilised to assign patients a socioeconomic quartile ranging from Q1 (most deprived) to Q4 (most affluent) and a numerical Deprivation Index Score (DIS). Results: A total of 529 patients were included, of which nine had sustained repeated facial fractures during the predetermined period. The majority of patients were male (86.43%), with a median age was 26.5 (Inter Quartile Range 20 – 36). Whilst the relative frequency of facial fractures was unaffected by area-level deprivation, fracture aetiology varied considerably across the social gradient. The incidence of assault-related fractures was significantly greater in low-income settings (Q1 versus Q3 + Q4, 66.07% versus 40.32%, p = 0.00046). Conversely, sport-related injuries were significantly more prevalent amongst affluent communities (Q3 + Q4 versus Q1 + Q2, 28.06% versus 17.89%, p = 0.0049). Conclusion: The increased incidence of assault-related fractures amongst deprived communities may be secondary to poor social cohesion and higher background levels of community violence. Furthermore, known risk factors for physical violence – namely drug and alcohol misuse – are more prevalent in low-income settings. Public policy should be directed at tackling endemic healthcare disparities that contribute to the unequal distribution of maxillofacial trauma.