NATIONAL

HEALTH BEHAVIOUR IN SCHOOL-AGED CHILDREN:
WHO COLLABORATIVE CROSS-NATIONAL STUDY (HBSC)
2014 SURVEY IN SCOTLAND NATIONAL REPORT
INJURIES
INTRODUCTION
Any physical damage to the body can be considered an injury; here we are concerned with injury that is sufficiently severe
to require medical treatment. In industrialised countries, injury is the single greatest cause of death in young people,
although prevalence of injury-related deaths is higher in low and middle-income countries 1 . The high frequency of nonfatal
injury (with around 50% of adolescents reporting a serious injury in the last year) makes injury a very important factor
in adolescent health 2 . Unintentional injuries accounted for approximately 1 in 7 emergency hospital admissions for children
in Scotland in 2011/2012 3 .
There is a link between socio-economic status (SES) and type of adolescent injury: low SES is associated with higher risk
of being injured through fighting and increased risk of being so severely injured as to require hospitalisation; high SES is
associated with higher risk of injury through sport or other recreational activity 4 .
Globally, the leading causes of injury among children are road traffic accidents, drowning, fire-related burns, self-harm
and violence 1 . Most non-fatal injuries occur in the home or at a sporting facility. Boys report higher levels of injury than
girls 5 , which is likely related to higher levels of risk-taking behaviours in boys. Early engagement in risky behaviours is
considered to be a marker for a trajectory that places young people at higher risk for physical injury 6 . Such behaviours are
the strongest predictor of risk of injury in adolescents 2 .
At the start of the period between 2005 and 2011, injury rate due to maltreatment and violence was twice as high in
Scotland as in England among 11-18 year olds. Over this six-year period, the disparity declined and the overall rate of such
injuries reduced, as did the rate of injuries in young people through causes unrelated to maltreatment or violence 7 . Scottish
data from the period 1982-2006 on death through injury in children 14 years and younger, followed the international
trend of higher rates in males. This was true for poisoning, falls, suicide, drowning, suffocation and road-traffic accidents.
However, this male excess declined markedly during the same time period 8 . Furthermore, it was found that children
residing in less affluent areas were at relatively greater risk of deaths related to head injury and this effect was strongest
in 10-14 year olds 9 .
A supportive social environment has been shown to reduce adolescent participation in risk-taking behaviours (such as
drunkenness, drug-use, non-use of seatbelts) and hence in risk of injury 10 . Societies that introduced initiatives to improve
safety for adolescents, appear to have succeeded in reducing injury morbidity 11 . In May 2011, NHS Health Scotland produced
a briefing on the prevention of unintentional injuries for children and young people 12 . This supplements the 2007 Child Safety
Strategy 13 , which outlines the Scottish Government’s framework for delivering improvements in healthcare for children
and young people in Scotland for the next ten years. Preventative health care proposals aimed at front-line practitioners,
clinical leaders and others involved in the planning and delivery of health services to children and their families are set out in
A New Look At Hall 4: The Early Years Good Health for Every Child 14 . The Child Safety Report Card was prepared in 2012 as a
means of measuring progress towards, and setting targets for reducing unintentional injury-related death and disability
amongst European children and adolescents 15 .
HBSC FINDINGS
Since 2002, the HBSC study has asked young people about injuries requiring medical attention during the previous
12 months. In 2014, young people were also asked where the most serious injury happened and what they were doing
when it occurred. Those that were injured were asked whether their most serious injury required hospital treatment.
MEDICALLY ATTENDED INJURIES
Almost half of young people (45%) suffered at least one medically-treated injury in the past 12 months. There is little variation
in the prevalence of injuries across the three age groups (Figure 15.1). However, at all three ages, more boys than girls have
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