Background: The aim was to examine temporal trends in injury mortality and morbidity across 30 countries in Europe and North America, and the impact of regional geography and adolescent risk behaviours (including substance use and physical fighting) on such trends. Methods: Data were obtained for 30 countries in 2002, 2006 and 2010. Mortality data were obtained from the World Health Organization's (WHO) Health for all database. Trends over time were described by WHO Regions using standardized rates comparisons and Poisson regression analyses. Results: Injury-related mortality, but not morbidity, declined over time across all countries (from 10 to 8 deaths per 100 000 between 2001 and 2010), with notable differences observed by Regions (e.g. from 48 to 39 deaths in Russia). Risk behaviours included in the models were consistently and significantly associated with injury morbidity, with substance increasing the risk for injury by 1.15 to 1.36 among girls, and physical fighting increasing the risk by 1.21 to 1.31 among boys across WHO Regions. Risk behaviours did not explain the observed temporal trends. Conclusions: Injury mortality and morbidity represent different health phenomena. Efforts that have been made to make societies safer for children have seemed to be successful in reducing injury morbidity.
Bibliographical noteFunding Information:
The HBSC study is an international survey conducted in collaboration with WHO/EURO. The International Coordinator of the study was Candace Currie, University of St Andrews, Scotland, and the data bank manager was Oddrun Samdal, University of Bergen, Norway. A complete list of participating countries and researchers is available on the HBSC website (http://www.hbsc.org). The data collection in each country was funded at the national level. We are grateful for the financial support offered by the various government ministries, research foundations and other funding bodies in the participating countries and regions.
© 2015 The Author. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.