presenting author: michal molcho
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The epidemiology of non-fatal injuries among 11, 13, and 15 year old youth in 11 countries: findings from the 1998 WHO-HBSC study. Presenting author: Michal Molcho. - PowerPoint PPT PresentationTRANSCRIPT
The epidemiology of non-fatal injuries among 11, 13, and 15 year old youth in
11 countries: findings from the 1998 WHO-HBSC study
The epidemiology of non-fatal injuries among 11, 13, and 15 year old youth in
11 countries: findings from the 1998 WHO-HBSC study
Presenting author:
Michal Molcho
Presenting author:
Michal Molcho
Reference: Molcho M., Harel Y., Pickett W. Schiedt P.C., Mazur J. Overpeck M.D. (2006). “The epidemiology of non fatal injuries among 11, 13 and 15 year old youth in 11 Countries: Findings from the 1998 WHO-HBSC cross national survey”. Injury Control and Safety Promotion (In press).
Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway
HBSC - background A cross-national research study conducted in
collaboration with the WHO Regional Office for Europe
HBSC was initiated in 1982 and is conducted every 4 years
HBSC 1998 involved more than 125,000 children from 29 countries
HBSC 2006 is expected to involve more than 180,000 children from 41 countries
Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway
HBSC 2006 – 41 regions
Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway
HBSC – some more background
The study aims to gain new insight into, and increase our understanding of young people's health and well-being, health behaviours and their social context
Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway
HBSC – topics covered
Demographics General health and well-being Family and peer relationships School environment Exercise and leisure time activities Substance use Violence and injuries Etc.
Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway
HBSC – some more background
The findings are used to inform and influence children’s policy and practice at national and international levels
The target age-groups are 11, 13 and 15 year olds attending school (n=4,500)
Sample sizes assured a 95% confidence interval of +/- 3% for prevalence estimates
Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway
Methodology - Data
1998 HBSC data from 11 countries: Belgium (Flemish sample), Canada, England, Hungary, Israel, Lithuania, Poland, Republic of Ireland, Sweden, Switzerland, and the USA
Sample of 52,955 schoolchildren
Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway
Methodology – Measures
Self reported medically attended injuries P12M
During the past 12 months, how many times were you injured, and had to be treated by a doctor or a nurse?
Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway
Methodology – Measures
Measures of severity
Injury that resulted with one or more days missed from school or usual activities
Injury that resulted in two or more of the following treatments: placement of a cast, stitches, use of crutches and surgery; or injury that resulted with overnight hospitalization Measures of severity were collected in 8 of the 11
countries
Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway
Methodology – Measures
Setting in which the injury occurred Where were you when this one most serious injury happened?
Activity during which the injury occurred
What were you doing when this one most serious injury happened?
FindingsFindings
International comparison of injuries
International comparison of injuries
Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway
Annual rates of medically attended injury and measures of severity per 100 by
country
50.4 50.3
47.4 47.445.5
42.2
39.037.8
35.7
29.9
24.1
9.4
5.6
12.412.2
14.6
18.1
23.9
18.7
15.3
30.6
20.0
6.8
12.9
8.08.7
10.38.0
6.05.8
0.0
10.0
20.0
30.0
40.0
50.0
60.0
Israel Ireland USA Hungary Switzerland England Lithuania Canada Sweden Belgium(Flemish)
Poland
All Medically Treated Injuries
Injuries Resulting in Activity loss
Injuries Resulting in Serious Consequences
Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway
Medically attended injury: Cross-tabulation of injuries, by setting and activity context for all
11 countries combined
Home (or yard)
School Sport Facility/Field
Street Other Total
Biking 27.6 8.2 7.7 46.7 9.7 100.0
14.0 5.0 4.4 39.3 10.2 13.3
Sport Activity 12.9 31.2 47.9 2.6 5.3 100.0
16.5 47.9 68.5 5.5 14.1 33.5
Walking/Running 34.2 26.1 7.3 20.2 12.2 100.0
17.1 15.7 4.1 16.7 12.6 13.1
Other 41.6 18.3 7.0 7.2 25.9 100.0
39.8 21.0 7.5 11.4 51.3 25.1
Total 3,866 3,212 3,450 2,330 1,869 14,727
26.3 21.8 23.4 15.8 12.7 100.0
Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway
Country specific medically attended annual injury estimates by setting per 100 injured
persons
26.6
33.4
29.7
26.2
36.7
23.5
17.3
25.4
29.727.0
21.823.3
12.5
29.326.9
14.0
20.1
15.8
25.323.3 22.0 22.1
21.1
15.4
18.521.223.2
26.1
17.6
23.023.9
22.5
13.9
0.0
10.0
20.0
30.0
40.0
50.0
60.0Home (or home yard) School Sport Facility
Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway
Country variation in medically attended injury percentage from about 24% in Poland to about 50% in Israel
Striking consistency with respect to the locations and mechanisms
In all 11 countries boys experienced more injuries than girls
No clear age trend was found internationally
Main findings - prevalence
Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway
Country specific medically attended annual injury estimates by activity per 100 injured
persons
39.9
49.7
27.5
36.4
29.9
33.3
26.6
3.7 2.95.0
3.9 4.7
10.8
20.1
11.88.7
17.9
13.1
22.5
8.0
21.6
8.0
14.4
5.84.46.0
0.0
10.0
20.0
30.0
40.0
50.0
60.0
Israel Ireland USA Hungary Lithuania Canada Sweden Belgium(Flemish)
Poland
Sport Activity Biking Fighting
Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway
High rates of bicycle relates injuries in Hungary (21.6%) and lower rates in Sweden, Canada and the US (11.8%, 8.0% and 8.0% respectively).
Klein et al.(2005) reported the relative lack of programs on bicycle safety for Hungary and more programs for Sweden, Canada and the US that corresponded with the percentages of school children using bicycle helmets in these countries
This may suggest that informed legislation and other injury prevention programs can play an important role in decreasing injury rates at the national level
Main findings – bicycle injuries
Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway
Cross-tabulation of severe injury rates by activity and type of severity measure for all
countries combined
Type of activity Activity loss Consequences
N % N %
Biking 1,913 13.0 1,947 14.8
Skating 1,131 7.5 1,157 9.1
Sport Activity 4,691 31.6 4,798 27.5
Riding in a Car 423 2.8 428 4.6
Walking/Running 1,771 11.7 1,835 12.7
Fighting 548 3.8 109 3.8
Other 3,462 29.7 3,513 27.6
Total 13,904 100.0 14,234 100.0
Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway
Overall, about 4% of all reported injuries were caused by fighting and this figure was consistent across the 11 countries
injuries due to fighting were responsible for only about 4% of all severe injuries, based upon both measures of severity used
Main findings – fighting
ConclusionsConclusions
So what have we learned?So what have we learned?
Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway
The high rates of injury among youth, in all 11 countries that collected these data in the WHO HBSC study indicate the universality of this problem
The cross-national similarities in locations are compelling
The three leading locations: home, school and sport facilities should be targeted as a high priority worldwide
Conclusions
Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway
The HBSC study does not provide in-depth information on injuries
data were collected during school class period. Thus, youth who were not in attendance at school were not represented
The study also relies upon self-reports and this involves use of individual students’ perceptions
Limitations
Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway
Mazur J., Scheidt P.C., Overpeck M.D., Harel Y., Molcho M. (2001). "Adolescents injuries in relation to economic status: An International perspective". Journal of Injury Control and Safety Promotion, 8(3) 179-182.
Pickett W., Garner M.J., Boyce W.F. and King M.A.(2002) “Gradients in risk for youth injury associated with multiple-risk behaviours: a study of 11,329 Canadian adolescents”. Social Science and Medicine, 55(6):1055-68.
Pickett W.; Schmid H.; Boyce W.F.; Simpson K.; Scheidt P.C.; Mazur J.; Molcho M.; King M.A..; Godeau E.; Overpeck M.; Aszmann A.; Szabo M.; Harel Y. (2002). "Multiple risk behavior and injury: an international analysis of young people". Archives of Pediatrics and Adolescent Medicine, 156:786-793
More “injury” papers from the HBSC
Vienna: 26 June, 2006 Dr Michal Molcho, NUI Galway
Pickett W, Molcho M, Simpson K, Janssen I, Kuntsche E, Mazur L, Harel Y, and Boyce WF (2005). “Cross-national study of injury and social determinants in adolescents”. Injury Prevention, 11:213-218.
Klein, K.S.; Thompson, D.; Scheidt P.C.; Overpeck, M.D.; Gross, L.A. (2005). “Factors associated with bicycle helmet use among young adolescents in a multinational sample”. Injury Prevention, 000:1-7.
Pickett W., Craig W., Harel Y., Cunningham J., Simpson K., Molcho M., Mazur J., Dostaler S. and Currie C.E. (2005). “Cross-national study of fighting and weapon carrying as determinants of adolescent injury”. Pediatrics 116(6):855-863.
More “injury” papers from the HBSC