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Nesje E, Valøy NN, Krüger AJ, Uleberg O. Epidemiology of paediatric trauma in Norway: a single-trauma centre observational study. Int J Emerg Med 2019; 12:18. [PMID: 31366380 PMCID: PMC6670199 DOI: 10.1186/s12245-019-0236-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 07/17/2019] [Indexed: 11/18/2022] Open
Abstract
Background Trauma is a major cause of mortality and morbidity in children globally. The burden of injury shows substantial geographical differences, with a significant mortality reduction in children in Norway during the last four decades. The aim was to describe the current epidemiology, resource use and outcome for all potential severely injured paediatric patients admitted to a Norwegian trauma centre. Methods This was a single-centre retrospective observational study. All patients aged 0–17 years received by a trauma team between 01 January 2004 and 31 December 2016 (13 years) at St. Olav’s University Hospital were included. Severe injury was defined as Injury Severity Score > 15. Results A total of 873 patients were included, of which 536 (61%) were male. The median age was 13 years (IQR 7–16). Six per cent (n = 52) of the patients were transferred from other hospitals. Blunt trauma constituted 98%, with traffic (n = 532/61%) and falls (n = 233/27%) as the most common mechanisms. Eight patients (1%) died within 30 days of hospital admission. Fifteen per cent (n = 128) were severely injured. Among the patients transferred from another hospital, 46% (n = 24) had severe injuries. Helicopter Emergency Medical Services (HEMS) were more used in younger age groups and in patients more severely injured. Conclusions In a developed healthcare system, the number of potentially severely injured children is small and with very few deaths following trauma. Transport and falls represent the most common causes of injury throughout all age groups, though with a tendency towards more transport-related injuries with increasing age. In-hospital trauma care is characterized by a low threshold for a multidisciplinary reception, low use of intensive care and need for emergency surgical procedures, though with increased need in the older children. Electronic supplementary material The online version of this article (10.1186/s12245-019-0236-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Eirik Nesje
- Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NO-7491, Trondheim, Norway
| | - Nadine Nalini Valøy
- Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, NO-7491, Trondheim, Norway
| | - Andreas Jorstad Krüger
- Department of Emergency Medicine and Pre-Hospital Services, St. Olav's University Hospital, NO-7006, Trondheim, Norway.,Department of Research and Development, Norwegian Air Ambulance Foundation, NO-0103, Oslo, Norway.,Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, NO-7006, Trondheim, Norway
| | - Oddvar Uleberg
- Department of Emergency Medicine and Pre-Hospital Services, St. Olav's University Hospital, NO-7006, Trondheim, Norway. .,Department of Research and Development, Norwegian Air Ambulance Foundation, NO-0103, Oslo, Norway. .,Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, NO-7006, Trondheim, Norway.
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Johansson L, Stenlund H, Bylund PO, Eriksson A. ER visits predict premature death among teenagers. ACCIDENT; ANALYSIS AND PREVENTION 2012; 48:397-400. [PMID: 22664705 DOI: 10.1016/j.aap.2012.02.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 01/17/2012] [Accepted: 02/14/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND The purpose of this study was to investigate if teenagers visiting an emergency room because of injury have an increased risk of premature death ahead and, if so, identify possible risk factors and suggest preventive measures. METHODS In January 2010, the personal identity numbers of 12,812 teenagers who had visited the emergency room at the University Hospital in Umeå, Sweden, during 1993 through 2006 because of injury were checked against the National Cause of Death Register in Sweden. Standardised mortality ratio and confidence intervals were calculated. For the unnatural deaths that took place in Sweden, the police report, autopsy protocol, and hospital records, if present, were studied. RESULTS Thirty-eight fatalities were included giving a standardised mortality ratio of 1.44 (95% CI: 1.02-1.98). A majority of the decedents were males (n=32, 84%) and the median age at the time of death was 21 years. Twenty-three deaths were caused by unintentional injuries and ten by intentional injuries (all suicides), while five deaths were categorised as undetermined whether intentional or not. Seventy-four percent tested positive for either alcohol or drugs or a combination at the post mortem examination. Nine males and one female committed suicide, five tested positive for alcohol (one also for drugs), while four tested negative at the post mortem examination. One died abroad and in this case we lack information on alcohol and drugs. CONCLUSION Teenagers visiting an emergency room due to injury experience an increased risk of premature death by unnatural cause and those at risk are especially males. The use of alcohol and drugs often seems to contribute to their untimely deaths. Identifying those at risk when they visit the emergency room for an injury and to take preventive actions at this stage could be a way to reduce the number of fatalities.
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Affiliation(s)
- Lars Johansson
- Department of Community Medicine and Rehabilitation, Section of Forensic Medicine, Umeå University, POB 7616, SE-907 12 Umeå, Sweden.
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Abstract
Research has consistently shown that low socioeconomic status (SES) is associated with an increased risk of poor health and death in adults and children. Studies from around the world have shown an inverse relationship between SES and childhood injury morbidity and mortality. For example, compared with children with high SES, children with low SES are at an increased risk of death from pedestrian collisions, fires, falls and drownings, and at an increased risk of hospitalization from recreation or play injuries. Research from England and Wales shows that these disparities in mortality between high and low SES children may be widening over time. This paper provides an overview of the literature on the relationship between SES and childhood injury morbidity and mortality, outlines the postulated mechanisms for this relationship, and highlights some intervention studies targeted to low SES children.
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Affiliation(s)
- Catherine S Birken
- Division of Paediatric Medicine (PORT), The Hospital for Sick Children, and Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario
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Fraga AMA, Fraga GP, Stanley C, Costantini TW, Coimbra R. Children at danger: injury fatalities among children in San Diego County. Eur J Epidemiol 2010; 25:211-7. [PMID: 20084430 PMCID: PMC2836467 DOI: 10.1007/s10654-009-9420-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2009] [Accepted: 12/31/2009] [Indexed: 11/30/2022]
Abstract
External causes of death are important in the pediatric population worldwide. We performed an analysis of all injury-fatalities in children between ages zero and 17 years, between January 2000 and December 2006, in San Diego County, California, United States of America. Information was obtained from the County of San Diego Medical Examiner’s database. External causes were selected and grouped by intent and mechanism. Demographics, location of death and relation between the injury mechanism and time of death were described. There were 884 medico-legal examinations, of which 480 deaths were due to external causes. There majority were males (328, 68.3%) and whites (190, 39.6%). The most prevalent mechanism of injury leading to death was road traffic accidents (40.2%), followed by asphyxia (22.7%) and penetrating trauma (17.7%). Unintentional injuries occurred in 65.8% and intentional injuries, including homicide and suicide, occurred in 24.2 and 9.4%, respectively. Death occurred at the scene in 196 cases (40.9%). Most deaths occurred in highways (35.3%) and at home (28%). One hundred forty-six patients (30.4%) died in the first 24 h. Seven percent died 1 week after the initial injury. Among the cases that died at the scene, 48.3% were motor vehicle accidents, 20.9% were victims of firearms, 6.5% died from poisoning, 5% from hanging, and 4% from drowning. External causes remain an important cause of death in children in San Diego County. Specific strategies to decrease road-traffic accidents and homicides must be developed and implemented to reduce the burden of injury-related deaths in children.
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Affiliation(s)
- Andrea M A Fraga
- Division of Trauma, Surgical Critical Care, and Burns, Department of Surgery, UCSD School of Medicine, University of California-San Diego, 200 West Arbor Drive, San Diego, CA 92103-8896, USA
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Waylen AE, McKenna FP. Risky attitudes towards road use in pre-drivers. ACCIDENT; ANALYSIS AND PREVENTION 2008; 40:905-911. [PMID: 18460357 DOI: 10.1016/j.aap.2007.10.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2007] [Revised: 10/03/2007] [Accepted: 10/18/2007] [Indexed: 05/26/2023]
Abstract
Motor vehicle accidents are one of the principal causes of adolescent disability or mortality and male drivers are more likely to be involved in road accidents than female drivers. In part such associations between driver age and sex have been linked to differences in risky behaviour (e.g. speed, violations) and individual characteristics (e.g. sensation seeking, deviant behaviour). The aim of this research is to determine whether associations between risky road user behaviour and individual characteristics are a function of driver behaviour or whether they are intrinsic and measurable in individuals too young to drive. Five hundred and sixty-seven pre-driver students aged 11-16 from three secondary schools completed questionnaires measuring enthusiasm for speed, sensation seeking, deviant behaviour and attitudes towards driver violations. Boys reported more risky attitudes than girls for all measures. Associations between sensation seeking, deviant behaviour and attitudes towards risky road use were present from early adolescence and were strongest around age 14, before individuals learn to drive. Risky attitudes towards road use are associated with individual characteristics and are observed in adolescents long before they learn to drive. Safe attitudes towards road use and driver behaviour should be promoted from childhood in order to be effective.
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Affiliation(s)
- Andrea E Waylen
- Health Sciences Research Institute, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK.
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Reimers AM, de Leon AP, Laflamme L. The area-based social patterning of injuries among 10 to 19 year olds. Changes over time in the Stockholm County. BMC Public Health 2008; 8:131. [PMID: 18430258 PMCID: PMC2377258 DOI: 10.1186/1471-2458-8-131] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2007] [Accepted: 04/23/2008] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Area-based studies of childhood injuries strongly suggest that neighborhood socio-demographic and economic circumstances impact on various - though not all - types of injuries. The primary aim of this study was to investigate the stability over time of the association between area characteristics and childhood injuries of various causes. METHODS Register-based and ecological, the study encompassed Stockholm County's 138 parishes, and considered two time periods (1993-95; 2003-05). Two indices were measured: economic deprivation and social fragmentation, and parishes were allocated to their respective quintile on each index. Data on both unintentional and intentional injuries for children (boys and girls) aged 10-14 and 15-19 respectively were gathered from the County Council's hospital inpatient register. For each period and index, gender, age and cause-specific comparisons were made to assess the rate ratios (with 95% confidence intervals) of being injured using parishes belonging to the best index level as a comparison group. A series of simple and partial Pearson correlations were also calculated to assess the independent contribution of each index. RESULTS Regardless of time period, there were rather few significant rate ratios and, when they occurred, there were both under and excess risks. For instance, in each period, boys from both age groups living in parishes with the highest levels of economic deprivation had lower rate of injury as a motor vehicle rider. Most strikingly, intentional injuries were more frequent during the second time period and in considerable excess among girls aged 15-19 from more economically deprived areas. Also, during that last period, none of the injury causes correlated significantly with the index of social fragmentation after adjustment for economic deprivation (partial correlation). CONCLUSION Over a ten-year period, differential economic deprivation among parishes has widened more than social fragmentation in Stockholm County. The correlation between those indices is high in both periods of time whilst the association between the levels of each index and injury rates varies depending on group of injuries or time period considered. It is of concern that intentional injuries have increased numerically and are significantly and positively correlated with economic deprivation (net of social fragmentation), in particular among girls.
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Affiliation(s)
- Anne-Mari Reimers
- Karolinska Institutet, Department of Public Health Sciences, Division of Social Medicine, SE-171 76 Stockholm, Sweden
- Centre for Public Health, Norrbacka, SE-171 76 Stockholm, Sweden
| | - Antonio Ponce de Leon
- Karolinska Institutet, Department of Public Health Sciences, Division of Social Medicine, SE-171 76 Stockholm, Sweden
- Department of Epidemiology, Institute of Social Medicine, University of Rio de Janeiro State (IMS/UERJ)
| | - Lucie Laflamme
- Karolinska Institutet, Department of Public Health Sciences, Division of International Health, SE-171 77 Stockholm, Sweden
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Polinder S, Meerding WJ, Mulder S, Petridou E, van Beeck E. Assessing the burden of injury in six European countries. Bull World Health Organ 2007; 85:27-34. [PMID: 17242755 PMCID: PMC2636210 DOI: 10.2471/blt.06.030973] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2006] [Revised: 09/04/2006] [Accepted: 09/06/2006] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To assess injury-related mortality, disability and disability-adjusted life years (DALYs) in six European countries. METHODS Epidemiological data (hospital discharge registers, emergency department registers, mortality databases) were obtained for Austria, Denmark, Ireland, Netherlands, Norway, and the United Kingdom (England and Wales). For each country, the burden of injury was estimated in years lost due to premature mortality (YLL), years lived with disability (YLD), and DALYs (per 1000 persons). FINDINGS We observed marked differences in the burden of injury between countries. Austria lost the largest number of DALYs (25 per 1000 persons), followed by Denmark, Norway and Ireland (17-20 per 1000 persons). In the Netherlands and United Kingdom, the total burden due to injuries was relatively low (12 per 1000 persons). The variation between countries was attributable to a high variation in premature mortality (YLL varied from 9-17 per 1000 persons) and disability (YLD varied from 2-8 per 1000 persons). In all countries, males aged 25-44 years represented one third of the total injury burden, mainly due to traffic and intentional injuries. Spinal cord injury and skull-brain injury resulted in the highest burden due to permanent disability. CONCLUSION The burden of injury varies considerably among the six participating European countries, but males aged 15-24 years are responsible for a disproportionate share of the assessed burden of injury in all countries. Consistent injury control policy is supported by high-quality summary measures of population health. There is an urgent need for standardized data on the incidence and functional consequences of injury.
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Affiliation(s)
- Suzanne Polinder
- Department of Public Health, Erasmus Medical Centre, University Medical Centre Rotterdam, Netherlands
| | - Willem Jan Meerding
- Department of Public Health, Erasmus Medical Centre, University Medical Centre Rotterdam, Netherlands
| | | | - Eleni Petridou
- Centre for Research and Prevention of Injuries, Department of Hygiene and Epidemiology, Athens University Medical School, Greece
| | - Ed van Beeck
- Department of Public Health, Erasmus Medical Centre, University Medical Centre Rotterdam, Netherlands
| | - EUROCOST Reference Group
- Department of Public Health, Erasmus Medical Centre, University Medical Centre Rotterdam, Netherlands
- Consumer Safety Institute, Amsterdam, Netherlands
- Centre for Research and Prevention of Injuries, Department of Hygiene and Epidemiology, Athens University Medical School, Greece
- EUROCOST Reference Group: Robert Bauer, Austrian Institute for Home and Leisure Safety / Sicher Leben, Austria; Claus Larsen, Copenhagen University Hospital, Denmark; Ronan Lyons, Centre for Health Improvement through Research and Evaluation (CHIRAL), Swansea Medical School, University of Wales Swansea, Wales; Tim McCarthy, Ministry of Health, Ireland; Catherine Pérez, Municipal Institute of Public Health, Spain; Alessio Pitidis, Department of Environment and Primary Prevention, National Institute of Health, Italy; Hidde Toet, Consumer Safety Institute, Amsterdam, Netherlands; Anne Mette Tranberg Kejs, National Institute of Pubic Health, Denmark; Johannes Wiik, Norwegian Institute of Public Health, Norway
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Michaud PA. Prevention and health promotion in school and community settings: a commentary on the international perspective. J Adolesc Health 2003; 33:219-25. [PMID: 14519562 DOI: 10.1016/s1054-139x(03)00180-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Pierre-André Michaud
- Multidisciplinary Unit for Adolescent Health, University Medical Center, Lausanne, Switzerland.
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9
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Kraus B, Stronski S, Michaud PA. Training needs in adolescent medicine of practising doctors: a Swiss national survey of six disciplines. MEDICAL EDUCATION 2003; 37:709-714. [PMID: 12895251 DOI: 10.1046/j.1365-2923.2003.01565.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To assess and compare the training needs in adolescent medicine of doctors within 6 specialties as a basis for the development of pre/postgraduate and continuing medical education (CME) training curricula. DESIGN Cross-sectional postal survey. SETTING Switzerland. PARTICIPANTS National, representative, random sample of 1857 practising doctors in 6 disciplines (general practitioners, paediatricians, gynaecologists, internists, psychiatrists, child psychiatrists) registered with the Swiss Medical Association. MAIN OUTCOME MEASURES Perceived importance of and training interest in 35 topics related to adolescent medicine listed in a self-administered, anonymous questionnaire. RESULTS A total of 1367 questionnaires were returned, representing a response rate of 73.9%. Clear interest in adolescent medicine was reported by 62.1% of respondents. Topics perceived to be the most important in everyday practice were functional symptoms (71.4%), acne (67.1%), obesity (64.6%), depression-anxiety (68.1%) and communication with adolescents (61.7%). Differences between disciplines were especially marked for gynaecologists, who expressed interest almost exclusively in medical topics specific to their field. In contrast, other disciplines commonly reported a keen interest in psychosocial problems. Accordingly, interest in further training was expressed mostly for functional symptoms (62.4%), eating disorders (56.3%), depression-anxiety (53.7%) and obesity (52.6%). Issues related to injury prevention, chronic disease and confidentiality were rated as low priorities. CONCLUSIONS Regardless of discipline, Swiss primary care doctors expressed a strong interest in adolescent medicine. Continuing medical education courses should include both interdisciplinary courses and discipline-specific sessions. Further training should address epidemiological and legal/ethical issues (e.g. injury prevention, confidentiality, impact of chronic conditions).
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Affiliation(s)
- Barbara Kraus
- Multidisciplinary Unit for Adolescent Health (UMSA), and Institute for Social & Preventive Medicine, University Hospital (CHUV), CH-1011 Lausanne, Switzerland
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Bockholdt B, Schneider V. The injury pattern to children involved in lethal traffic accidents in Berlin. Leg Med (Tokyo) 2003; 5 Suppl 1:S390-2. [PMID: 12935640 DOI: 10.1016/s1344-6223(02)00139-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A statistical investigation of causes of death of children in Berlin, as well as in the rest of Germany shows, that 'accidents' are the most frequent causes of death in children. Nearly 50% of all child fatalities (0-15 years old) are due to traffic accidents. The reports of 30 children (19 boys, 11 girls) that were investigated in one of the three Institutes of Legal Medicine in Berlin over a period of 5 years were studied. In nearly 40% of all cases the children were pedestrians, in ten cases they died as passengers in cars, five children were bicyclists and in one case the child was a skateboarder. In 60% of all cases the principal injuries were severe injuries of the skull and brain; skull and brain trauma was the most frequent cause of death. In the group pedestrians (n=11), the cause of death in ten cases was the severe head-injury. Over 60% of all injured children died at the scene or in the first 24h after the accident, none of the children survived more than 30 days.
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Affiliation(s)
- Britta Bockholdt
- Department of Legal Medicine, Free University Berlin, Hittorfstrasse 18, 14195 Berlin, Germany.
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Williamson LM, Morrison A, Stone DH. Trends in head injury mortality among 0-14 year olds in Scotland (1986-95). J Epidemiol Community Health 2002; 56:285-8. [PMID: 11896136 PMCID: PMC1732128 DOI: 10.1136/jech.56.4.285] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
STUDY OBJECTIVE To examine the trends in childhood head injury mortality in Scotland between 1986 and 1995. DESIGN Analysis of routine mortality data from the registrar general for Scotland. SETTING Scotland, UK. SUBJECTS Children aged 0-14 years. MAIN RESULTS A total of 290 children in Scotland died as a result of a head injury between 1986 and 1995. While there was a significant decline in the head injury mortality rate, head injury as a proportion of all injury fatalities remained relatively stable. Boys, and children residing in relatively less affluent areas had the highest head injury mortality rates. Although both these groups experienced a significant decline over the study period, the mortality differences between children in deprivation categories 1-2 and 6-7 persisted among 0-9 year olds, and increased in the 10-14 years age group. Pedestrian accidents were the leading cause of mortality. CONCLUSIONS Children residing in less affluent areas seem to be at relatively greater risk of sustaining a fatal head injury than their more affluent counterparts. While the differences between the most and least affluent have decreased overall, they have widened among 10-14 year olds. The decline in head injury mortality as a result of pedestrian accidents may be partly attributable to injury prevention measures.
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Affiliation(s)
- L M Williamson
- Paediatric Epidemiology and Community Health (PEACH) Unit, Department of Child Health, University of Glasgow, Royal Hospital for Sick Children, Yorkhill, Glasgow G3 8SJ, UK
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Abstract
BACKGROUND The aim of the present paper was to assess the incidence of, and identify factors associated with road crash (RC)-related fatal head injuries in rural and metropolitan Western Australia. METHODS Examination of demographics, driving behaviour and RC characteristics for RC fatalities involving a head injury (Abbreviated Injury Scale (AIS) > or = 2) between 1 January 1998 and 31 December 1999 was carried out using the State Coronial Database. RESULTS There were 328 deaths. The median age was 28 years and 74.1% of cases were male. Seventy per cent died at the scene. Of scene survivors, 89% were transferred to a metropolitan hospital before dying. Sixty per cent of total RC and 65% of at-scene deaths occurred in rural areas. Single-vehicle crashes comprised 45% of total crashes, of which 72.8% occurred in rural locations. Poor driver behaviour was identified in 53% of deaths. Ethanol was implicated in 29.8% of deaths, other intoxicating drugs were implicated in 19.2%, speeding was implicated in 19.5%, and lack of safety restraints/devices was implicated in 22%. Poor driver behaviour was identified in 72% of single-vehicle deaths, compared with 38% of multivehicle crashes (P < 0.001). Rural people comprised 61% of rural crash victims. Ninety-one per cent of rural victims died in rural crashes. The incidence of RC death associated with head injury in the rural population is 13.4 deaths/100 000 per year, more than double that for the metropolitan population (6.4 deaths/100 000 per year; P < 0.001). CONCLUSION The rural population of Western Australia is overrepresented in head injury-related RC deaths. Single-vehicle crashes where unsafe driving behaviour is implicated comprise a large proportion of these. Strategies to reduce unsafe driving practices aimed at rural drivers are necessary.
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Affiliation(s)
- J Stella
- Emergency Department, Fremantle Hospital and Forensic Pathology Department, Pathcentre, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
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Abstract
PURPOSE To study the prevalence of physical fighting among youth and its association with personal and school-related factors. METHODS Pupils in the 8th and 10th grades (n = 1182, ages 13-16 years) in 11 Jerusalem secular and religious schools anonymously completed the World Health Organization questionnaire from the Health Behavior in School Children study. The unit of analysis was defined as the number of times the student was involved in physical fighting during the past year. The independent variables studied were sociodemographic characteristics, personal, and school-related factors including teachers, peers, and family. RESULTS Fighting at least once was reported by 76% of boys and 26% of girls; 6% of boys who were involved in fights at least once and 16% more than once required medical treatment. For boys, bullying others, poor health and mental health score, and perception of teachers that the pupil was a below-average student significantly increased the odds ratio (OR) for fighting more than once in the past year. Among girls, poor mental health, poor parental support on school matters, bullying, and being bullied by others increased the OR for fighting. CONCLUSIONS Fighting is a highly prevalent behavior among adolescents irrespective of their socioeconomic background. Determinants differ by gender, and intervention programs should focus on the gender-specific determinants.
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Affiliation(s)
- R Gofin
- Department of Social Medicine, Hadassah Medical Organization, Jerusalem, Israel
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