268 Multiple deprivation and unintentional poisoning in British Columbia, Canada

<h3>Background</h3> Poisoning is the leading cause of injury death and the second leading cause for injury-related hospitalization in British Columbia (B.C). Recent estimates show that unintentional poisoning (including misuse, abuse, or overdose of prescription and illicit drugs) is responsible for 84% of total poisoning costs in B.C. While previous research has demonstrated inequities in poisoning-related emergency department visits and hospital admission rates across social and material deprivation spectrums, the specific deprivation profile of the most vulnerable groups has not been previously described. <h3>Objective</h3> To demonstrate the socio-demographic profile and involved substances in serious home-based unintentional poisonings in B.C. and to determine the hospitalization rates across neighbourhood deprivation quintiles. <h3>Methods</h3> British Columbians who were hospitalized for unintentional poisoning at home from 2015 to 2019 were eligible for inclusion in this study, using the variables sex, age-group, substances involved, and the dissemination area of the place of residence. Using de-identified administrative data, we used the Canadian Index of Multiple Deprivation to categorize marginalization of the area of residence into quintiles (with quintile 5 representing the most deprived areas) across four dimensions of residential instability, economic dependency, ethno-cultural composition, and situational vulnerability. <h3>Results</h3> A total of 4,559 British Columbians were admitted for unintentional poisoning occurring at home across the study period, of whom 50.5% were male (annual rate: 18.51 per 100,000). Some 13.3% were under 19 years of age, 31.3% were 19–44, 28.7% were 45–64 and 26.7% were 65 years of age or older. The most common involved substances were narcotics and hallucinogens (32.9%) followed by anti-epileptic and sedative-hypnotic drugs (24.4%). The highest hospitalization rates were observed for quintile 5 of situational vulnerability composition (33.44 per 100,000), followed by quintile 5 of economic dependency (28.7) and residential instability (27.39). <h3>Conclusions</h3> The rate of serious unintentional poisoning was highest for quintile 5 of situational vulnerability, which reflects the most deprived areas regarding housing and education. Equity-oriented approaches are essential to decrease the observed gap between the least and the most deprived populations, by reducing differential exposures, vulnerability and consequences of unintentional poisoning among marginalized populations.