Cross national study of injury and social determinants in adolescents

Abstract

Objectives: To compare estimates of the prevalence of injury among adolescents in 35 countries, and to examine the consistency of associations cross nationally between socioeconomic status then drunkenness and the occurrence of adolescent injury. Design: Cross sectional surveys were obtained from national samples of students in 35 countries. Eight countries asked supplemental questions about injury. Setting: Surveys administered in classrooms. Subjects: Consenting students (n = 146 440; average ages 11-15 years) in sampled classrooms. 37 878 students (eight countries) provided supplemental injury data. Exposure measures: Socioeconomic status (material wealth, poverty) and social risk taking (drunkenness). Outcome measures: Specific types and locations of medically treated injury. Results: By country, reports of medically treated injuries ranged from 33% (1060/3173) to 64% (1811/ 2833) of boys and 23% (740/3172) to 51% (1485/2929) of girls, annually. Sports and recreation were the most common activities associated with injury. High material wealth was positively (OR.1.0; p,0.05) and consistently (6/8 countries) associated with medically treated and sports related injuries. Poverty was positively associated with fighting injuries (6/8 countries). Drunkenness (social risk taking) was positively (p,0.01) and consistently (8/8 countries) associated with medically treated, street, and fighting injuries, but not school and sports related injuries. Conclusion: The high prevalence of adolescent injury confirms its importance as a health problem. Social gradients in risk for adolescent injury were illustrated cross nationally for some but not all types of adolescent injury. These gradients were most evident when the etiologies of specific types of adolescent injury were examined. Prevention initiatives should focus upon the etiologies of specific injury types, as well as risk oriented social contexts.

Le phénomène du masquage dans le signalement des événements« les plus graves » : biais influant sur les estim tions des taux d’incidence des blessures sportives chez les enfants canadiens

“…Les blessures accidentelles entraînent de graves problèmes de santé et sont considérées comme l'une des principales causes de mortalité chez les jeunes à l'échelle de la planète 1,2 . Une proportion importante de blessures chez les jeunes survient lors de la pratique d'un sport ou d'une activité physique (« blessures sportives ») 3,4,5 .…”

“…Diverses enquêtes de mesure de la santé, telles que l'Enquête sur les comportements liés à la santé des enfants d'âge scolaire (ECSEAS) 2 , l'Enquête mondiale réalisée en milieu scolaire sur la santé des élèves (« GSHS ») 6 , l'Enquête sur la santé dans les collectivités canadiennes (ESCC), l'Enquête longitudinale nationale sur les enfants et les jeunes (ELNEJ) 7 et l'Enquête nationale sur la santé de la population (ENSP), utilisent des questions portant sur les circonstances entourant « la blessure la plus grave » subie par les répon-dants 8 . Il s'agit en général d'une blessure qui impose des limites à l'accomplissement des activités quotidiennes 5,8,9 ou nécessite un traitement administré par un médecin ou une infirmière 2,6,8 .…”

“…Il s'agit en général d'une blessure qui impose des limites à l'accomplissement des activités quotidiennes 5,8,9 ou nécessite un traitement administré par un médecin ou une infirmière 2,6,8 . Cependant, parmi les enquêtes que nous avons étudiées, seule l'ECSEAS définit explicitement ce qui est entendu par « la blessure la plus grave », à savoir la blessure qui « a mis le plus de temps à guérir » 2 .…”

Trends in Medically Attended Injuries in Czech Adolescents.

“…Only then can the development and evaluation of interventions take place before the implementation of public health injury prevention. Behavioural risk factors for injury include: alcohol consumption, fighting, sports participation, and other multiple risk behaviours (7)(8)(9). Czech adolescents have one of the highest rates of reporting one medically attended injury when compared to other European and North American countries (8), however, fewer adolescents report more than one injury in the past year, bringing the overall injury rates in the Czech Republic to below the median.…”

“…Even though the changes in the law such as the use of bike helmets have been praised, the challenges of addressing educational means for reducing accidents by falls, drownings and scalds is still a pertinent area for improvement in the Czech Republic (14). In addition, since sports related injuries can range from 30-50% of the medically attended injuries (8,16), safety promotion in sports training needs to be also covered. This could range from training programs that aim to improve physical conditioning to an array of studies that explore rule modifications to enhance the safety aspects of the game (17).…”