Association between spatial accessibility to fire protection services and unintentional residential fire injuries or deaths: a cross-sectional study in Dallas, Texas

OBJECTIVES: In addition to neighbourhood characteristics encompassing racial composition, socioeconomic status and housing environments, it was unclear if location characteristics relating to the accessibility of fire protection services were risk factors for unintentional residential fire-related injuries in urban areas. This study was aimed to measure spatial accessibility to fire protection services at the census block group level, and examine whether it is associated with unintentional residential fire-related injuries. DESIGN: A cross-sectional study. SETTING: Unintentional residential fire incidents between 2012 and 2015 in Dallas City, Texas, USA. MAIN OUTCOME MEASURES: Using multiple logistic regression, the study analysed association between unintentional residential fire incidents in the city and risk factors, including spatial accessibility to fire protection services, measured by the two-step floating catchment area method. RESULTS: Compared with incidents without any injuries, fire incidents involving injuries were significantly more likely to include unconfined fire, fire originating in a cooking area, a bedroom for less than five people or a common family area, census block groups with >75% African American residents, >25% elderly single-person households and positive population growth rates <25% or >25%. Incidents involving injuries were significantly less likely to occur in areas with high spatial accessibility, as measured by spatial accessibility score. CONCLUSIONS: In addition to fire characteristics and neighbourhood demographics, spatial accessibility to fire protection services was significantly associated with unintentional residential fire-related injuries. The findings can be used to help select locations of additional fire stations.