The Road User Behaviours of Chinese Adolescents: Data From China and a Comparison With Adolescents in Other Countries

National and sub-national levels and causes of mortality among 5-19-year-olds in China in 2004-2019: A systematic analysis of evidence from the Disease Surveillance Points System

Background

China accounts for 13% of the world’s 5-19-year-olds population. We estimated levels and trends of mortality by sex-age-cause among 5-19-year-olds at national and subnational levels in China annually from 2004 to 2019, to inform strategies for reducing child and adolescent mortality in China and other countries.

Methods

We used adjusted empirical data on levels and causes of deaths from the China Center for Disease Control and Prevention’s Disease Surveillance Point (DSP) system. We considered underreporting and surveillance sampling design, applied smoothing techniques to produce reliable time trends, and fitted age-specific deaths and population to national estimates produced by international agencies to allow for cross-national comparisons.

Results

The top leading causes for 54 594 deaths among 5-19-year-olds were neoplasms, road traffic injuries, and drowning. All-cause mortality in 5-19-year-olds has been declining steadily between 2004-2019, with evident yet narrowing geographical and gender disparities. Injury mortalities were one of the fastest declining causes, but widespread disparities were observed across subpopulations. Falling injuries and rising non-communicable diseases had the most pronounced epidemiological transition in the eastern region. Decrease in drowning fractions stalled for 15-19-year-olds in central/western rural areas. Suicide shares sustained or increased for 15-19-year-olds except among females in eastern rural areas.

Conclusions

China made significant improvements in child and adolescent survival since 2004. However, constant targeted investments are needed to maintain and accelerate progress. A sustainable sample registration system like the DSP is likely essential for supporting such a process.

Child-Pedestrian Traffic Safety at Crosswalks—Literature Review

Child pedestrians make up 30% of the total number of children injured in road traffic in the EU. They are a particularly vulnerable subgroup because they exhibit specific traffic behavior related to cognitive and physical development, sociodemographic characteristics, and environmental conditions. This paper provides an overview of research of parameters that affect the safety of children in the conflict zones of the intersection—crosswalks. The overview was undertaken targeting available research mostly conducted in the last 10 years all over the world, related to the identification of parameters that affect the safety of child-pedestrians, and models developed for the prediction of pedestrian and child-pedestrian behavior. Research conducted on various urban networks provides insight into locally and more widely applicable impact parameters connected to child characteristics and infrastructural and traffic elements, but also distractors (e.g., electronic devices) as new phenomena influencing children’s road safety. A review of pedestrian behavior-prediction models suggests that models are being developed for the general population, and models for children’s behavior, with specific parameters, are missing. For further research, more detailed analysis of the impact of distractors and of COVID–19 pandemic non-mobility, as well as an analysis of possible infrastructural solutions to increase children’s road traffic safety, is suggested.

Motor Vehicle Collisions during Adolescence: The Role of Alexithymic Traits and Defense Strategies

International literature has shown that adolescents represent the population most at risk of fatal and nonfatal motor vehicle collisions (MVCs). Adolescents’ alexithymic traits and significant use of immature defense strategies have been seen to play a key role. This study aimed to investigate the possible mediation role played by defense strategies use in the relationship between alexithymia and MVCs. Our sample consisted of 297 adolescents divided into four subgroups, based on the number of visits to the emergency department due to an MVC. We assessed adolescents’ alexithymic traits and defense strategies use through self-report instruments. Results showed that males reported a higher rate of MVCs than females. Higher rates of MVCs are associated with more alexithymic traits and maladaptive defense strategies use. Adolescents’ Acting Out and Omnipotence use significantly mediated the relationship between alexithymia and MVCs. Our findings suggest the recidivism of MVCs as an attempt to cope with emotional difficulties, with important clinical implications.

Comparative Analyses of Parameters Influencing Children Pedestrian Behavior in Conflict Zones of Urban Intersections

Children pedestrians make up 30% of the total number of children injured in road traffic in the EU. Research shows that children are injured more often in the urban areas, in residential areas near schools and parks, often at intersections and pedestrian crossings. In this study, children’s traffic behavior was analyzed by observation of signalized pedestrian crosswalks. According to the same methodology, the research was conducted in three cities in two countries (Enna, Italy, Osijek and Rijeka, Croatia) with different urban and traffic characteristics. A total of 900 measurements were analyzed, 300 in each of the cities at 18 pedestrian crosswalks located in an urban setting in the vicinity of primary schools. A detailed statistical analysis of the influence parameters shows that, as general influence parameters, pedestrian crosswalk length, movement in a group and the age of children can be distinguished. Factors that have proven to have a significant influence on the movement of children in two of the three cities observed are gender, supervision by adults, running and cellphone use. The result can serve as a valuable input for interventions in traffic education as well as a basis for the improvement of traffic conditions at intersections where children are regularly present.