Background: Southwestern Ontario largely comprises rural farming districts and is home to numerous Old-Order Anabaptist settlements. Our objective was to describe the injuries sustained by rural children, both Old-Order Anabaptist and non-Anabaptist, to better target injury prevention programs.

Methods: We retrospectively examined injury data of rural children in Southwestern Ontario with injury severity scores ≥12 obtained from hospital and trauma databases (1997–2007).

Results: A total of 422 rural children were included in this study: 7.8% Anabaptist (n = 33) and 92.2% non-Anabaptist (n = 389). The age of injured Anabaptist children (median, 7 years; interquartile range = 10) was younger than non-Anabaptist children (median, 14 years; interquartile range = 7; p < 0.001). Anabaptist children were most frequently injured on their property (48.5%; n = 16 of 33; p < 0.001). Non-Anabaptist children were mostly injured on roads (56.8%; n = 221 of 389; p < 0.05) and by motor vehicle collisions (MVCs; 40.1%; n = 156 of 389; p = 0.02). Frequent causes of injury among Anabaptist children were falls (24.2%; n = 8 of 33; p = 0.02), animals (15.2%; n = 5 of 33; p = 0.004), and buggies (9.1%; n = 3 of 33). Approximately half of both groups injured in MVCs did not use seat belts. There were no significant differences between cohorts in sex, injury severity scores, hospitalization days, rates of complications, interventions, comorbidities, or mortality rates.

Conclusions: Injuries to Anabaptist children occur at a young age, primarily on their property, and exhibit a unique spectrum of mechanisms. In contrast, injuries to non-Anabaptist children occur at an older age, primarily on roads, and in MVCs. The use of protective devices was low among all rural children. Development of collaborative injury prevention programs targeted to distinct rural communities, including Anabaptist and non-Anabaptist, are needed for reducing injuries among rural children.