Rates of serious injury among child pedestrians in poor areas of England are four times as high as those among children in affluent areas, finds research published ahead of print in the Archives of Disease in Childhood.
The findings are based on an analysis of hospital admission rates for children aged up to 15 between 1999 and 2004.
Almost 664,000 children up to the age of 15 were admitted to hospital during this period, of which almost 8,000 were for serious injuries.
These were classified as neck and thigh fractures, multiple rib fractures, head injuries, neural and spinal cord injuries, suffocation, and hypothermia.
Falls accounted for over a third of all admissions, and for more than four out of 10 serious injuries.
Transport injuries made up one in 10 of all admissions and for almost one in three of those for serious injuries.
Children living in the most deprived areas of the country were four times as likely to sustain a serious injury as a pedestrian as children living in the most affluent areas.
And cyclists, car passengers, and children who sustained a fall from deprived areas were twice as likely to be seriously injured as their affluent peers.
Rates of serious injury for child pedestrians were generally lower in towns and villages than in cities. But there were significant variations.
The rate of serious injury sustained by child cyclists was 22% lower in London than in other cities.
And children in cars were 50% more likely to be seriously injured in villages than they were in cities.
Serious injuries resulting from falls were 60% higher in London and more than 20% lower in villages than they were in other major urban areas.
Deaths from child injuries have fallen over the past 20 years from 11 to 4 for every 100,000 children. But steep inequalities between rich and poor remain, say the authors.