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Published in: BMC Public Health 1/2008

Open Access 01-12-2008 | Research article

Adolescents' health and health behaviour as predictors of injury death. A prospective cohort follow-up of 652,530 person-years

Authors: Ville M Mattila, Jari Parkkari, Leena Koivusilta, Tapio Nummi, Pekka Kannus, Arja Rimpelä

Published in: BMC Public Health | Issue 1/2008

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Abstract

Background

Injuries represent an important cause of mortality among young adults. Longitudinal studies on risk factors are scarce. We studied associations between adolescents' perceived health and health behaviour and injury death.

Methods

A prospective cohort of 57,407 Finns aged 14 to 18 years was followed for an average of 11.4 years. The end-point of study was injury death or termination of follow-up in 2001. The relationships of eight health and health behaviour characteristics with injury death were studied with adjusted Cox's proportional hazard model.

Results

We identified 298 (0.5%) injury deaths, 232 (0.9%) in men and 66 (0.2%) in women. The mean age at death was 23.8 years. In the models adjusted for age, sex and socioeconomic background, the strongest risk factors for injury death were recurring drunkenness (HR 2.1; 95% CI: 1.4–3.1) and daily smoking (HR 1.7; 95% CI: 1.3–2.2). Poor health did not predict injury death. Unintentional and intentional injury deaths had similar health and health behavioural risk factors.

Conclusion

Health compromising behaviour adopted at adolescence has a clear impact on the risk of injury death in adulthood independent from socioeconomic background. On the other hand, poor health as such is not a significant predictor of injury death. Promotion of healthy lifestyle among adolescents as part of public health programmes would seem an appropriate way to contribute to adolescent injury prevention.
Literature
1.
go back to reference The injury chart book: A graphical overview of the global burden of injuries. Edited by: Peden M, McGee K, Sharma G. 2002, Geneva , WHO The injury chart book: A graphical overview of the global burden of injuries. Edited by: Peden M, McGee K, Sharma G. 2002, Geneva , WHO
2.
go back to reference Peden M, Mcgee R, Krug EGE: Injury: A leading cause of the global burden of disease. 2000, Geneva , WHO, 56- Peden M, Mcgee R, Krug EGE: Injury: A leading cause of the global burden of disease. 2000, Geneva , WHO, 56-
3.
go back to reference Schwarz DF, Grisso JA, Miles CG, Holmes JH, Wishner AR, Sutton RL: A longitudinal study of injury morbidity in an African-American population. JAMA. 1994, 271 (10): 755-760. 10.1001/jama.271.10.755.CrossRefPubMed Schwarz DF, Grisso JA, Miles CG, Holmes JH, Wishner AR, Sutton RL: A longitudinal study of injury morbidity in an African-American population. JAMA. 1994, 271 (10): 755-760. 10.1001/jama.271.10.755.CrossRefPubMed
4.
go back to reference Parkkari J, Mattila V, Niemi S, Kannus P: Injury-related deaths among Finnish children, 1971-2001. JAMA. 2003, 289 (6): 702-703. 10.1001/jama.289.6.702.CrossRefPubMed Parkkari J, Mattila V, Niemi S, Kannus P: Injury-related deaths among Finnish children, 1971-2001. JAMA. 2003, 289 (6): 702-703. 10.1001/jama.289.6.702.CrossRefPubMed
5.
go back to reference Hussey JM: The effects of race, socioeconomic status, and household structure on injury mortality in children and young adults. Matern Child Health J. 1997, 1 (4): 217-227. 10.1023/A:1022318610868.CrossRefPubMed Hussey JM: The effects of race, socioeconomic status, and household structure on injury mortality in children and young adults. Matern Child Health J. 1997, 1 (4): 217-227. 10.1023/A:1022318610868.CrossRefPubMed
6.
go back to reference Laflamme L, Engstrom K: Socioeconomic differences in Swedish children and adolescents injured in road traffic incidents: cross sectional study. BMJ. 2002, 324 (7334): 396-397. 10.1136/bmj.324.7334.396.CrossRefPubMedPubMedCentral Laflamme L, Engstrom K: Socioeconomic differences in Swedish children and adolescents injured in road traffic incidents: cross sectional study. BMJ. 2002, 324 (7334): 396-397. 10.1136/bmj.324.7334.396.CrossRefPubMedPubMedCentral
7.
go back to reference Roberts I, Power C: Does the decline in child injury mortality vary by social class? A comparison of class specific mortality in 1981 and 1991. BMJ. 1996, 313 (7060): 784-786.CrossRefPubMedPubMedCentral Roberts I, Power C: Does the decline in child injury mortality vary by social class? A comparison of class specific mortality in 1981 and 1991. BMJ. 1996, 313 (7060): 784-786.CrossRefPubMedPubMedCentral
8.
go back to reference Hambidge SJ, Davidson AJ, Gonzales R, Steiner JF: Epidemiology of pediatric injury-related primary care office visits in the United States. Pediatrics. 2002, 109 (4): 559-565. 10.1542/peds.109.4.559.CrossRefPubMed Hambidge SJ, Davidson AJ, Gonzales R, Steiner JF: Epidemiology of pediatric injury-related primary care office visits in the United States. Pediatrics. 2002, 109 (4): 559-565. 10.1542/peds.109.4.559.CrossRefPubMed
9.
go back to reference Leon DA, Saburova L, Tomkins S, Andreev E, Kiryanov N, McKee M, Shkolnikov VM: Hazardous alcohol drinking and premature mortality in Russia: a population based case-control study. Lancet. 2007, 369 (9578): 2001-2009. 10.1016/S0140-6736(07)60941-6.CrossRefPubMed Leon DA, Saburova L, Tomkins S, Andreev E, Kiryanov N, McKee M, Shkolnikov VM: Hazardous alcohol drinking and premature mortality in Russia: a population based case-control study. Lancet. 2007, 369 (9578): 2001-2009. 10.1016/S0140-6736(07)60941-6.CrossRefPubMed
10.
go back to reference Dischinger PC, Mitchell KA, Kufera JA, Soderstrom CA, Lowenfels AB: A longitudinal study of former trauma center patients: the association between toxicology status and subsequent injury mortality. J Trauma. 2001, 51 (5): 877-84; discussion 884-6.CrossRefPubMed Dischinger PC, Mitchell KA, Kufera JA, Soderstrom CA, Lowenfels AB: A longitudinal study of former trauma center patients: the association between toxicology status and subsequent injury mortality. J Trauma. 2001, 51 (5): 877-84; discussion 884-6.CrossRefPubMed
11.
go back to reference Neeleman J, Wessely S, Wadsworth M: Predictors of suicide, accidental death, and premature natural death in a general-population birth cohort. Lancet. 1998, 351 (9096): 93-97. 10.1016/S0140-6736(97)06364-2.CrossRefPubMed Neeleman J, Wessely S, Wadsworth M: Predictors of suicide, accidental death, and premature natural death in a general-population birth cohort. Lancet. 1998, 351 (9096): 93-97. 10.1016/S0140-6736(97)06364-2.CrossRefPubMed
12.
go back to reference Riley AW, Harris SK, Ensminger ME, Ryan S, Alexander C, Green B, Starfield B: Behavior and injury in urban and rural adolescents. Injury Prevention. 1996, 2 (4): 266-273.CrossRefPubMedPubMedCentral Riley AW, Harris SK, Ensminger ME, Ryan S, Alexander C, Green B, Starfield B: Behavior and injury in urban and rural adolescents. Injury Prevention. 1996, 2 (4): 266-273.CrossRefPubMedPubMedCentral
13.
go back to reference Alexander CS, Somerfield MR, Ensminger ME, Kim YJ, Jonhson KE: Gender differences in injuries among rural youth. Injury Prevention. 1995, 1 (1): 15-20.CrossRefPubMedPubMedCentral Alexander CS, Somerfield MR, Ensminger ME, Kim YJ, Jonhson KE: Gender differences in injuries among rural youth. Injury Prevention. 1995, 1 (1): 15-20.CrossRefPubMedPubMedCentral
14.
go back to reference Mattila V, Parkkari J, Kannus P, Rimpela A: Occurrence and risk factors of unintentional injuries among 12- to 18-year-old Finns--a survey of 8219 adolescents. Eur J Epidemiol. 2004, 19 (5): 437-444. 10.1023/B:EJEP.0000027355.85493.cb.CrossRefPubMed Mattila V, Parkkari J, Kannus P, Rimpela A: Occurrence and risk factors of unintentional injuries among 12- to 18-year-old Finns--a survey of 8219 adolescents. Eur J Epidemiol. 2004, 19 (5): 437-444. 10.1023/B:EJEP.0000027355.85493.cb.CrossRefPubMed
15.
go back to reference Mattila VM, Parkkari JP, Rimpela AH: Risk factors for violence and violence-related injuries among 14- to 18-year-old Finns. J Adolesc Health. 2006, 38 (5): 617-620. 10.1016/j.jadohealth.2005.03.007.CrossRefPubMed Mattila VM, Parkkari JP, Rimpela AH: Risk factors for violence and violence-related injuries among 14- to 18-year-old Finns. J Adolesc Health. 2006, 38 (5): 617-620. 10.1016/j.jadohealth.2005.03.007.CrossRefPubMed
16.
go back to reference Ma D, Morley R, Jones G: Risk-taking, coordination and upper limb fractures in children: a population based case-control study. Osteoporos Int. 2004, 15 (8): 633-638. 10.1007/s00198-003-1579-9.CrossRefPubMed Ma D, Morley R, Jones G: Risk-taking, coordination and upper limb fractures in children: a population based case-control study. Osteoporos Int. 2004, 15 (8): 633-638. 10.1007/s00198-003-1579-9.CrossRefPubMed
17.
go back to reference Avi A, Yehonatan S, Alon S, Alexandra H, Arieh E: Do accidents happen accidentally? A study of trauma registry and periodical examination database. Journal of Trauma-Injury Infection & Critical Care. 2001, 50 (1): 20-23. 10.1097/00005373-200101000-00003.CrossRef Avi A, Yehonatan S, Alon S, Alexandra H, Arieh E: Do accidents happen accidentally? A study of trauma registry and periodical examination database. Journal of Trauma-Injury Infection & Critical Care. 2001, 50 (1): 20-23. 10.1097/00005373-200101000-00003.CrossRef
18.
go back to reference Rivara FP, Koepsell TD, Jurkovich GJ, Gurney JG, Soderberg R: The effects of alcohol abuse on readmission for trauma. JAMA. 1993, 270 (16): 1962-1964. 10.1001/jama.270.16.1962.CrossRefPubMed Rivara FP, Koepsell TD, Jurkovich GJ, Gurney JG, Soderberg R: The effects of alcohol abuse on readmission for trauma. JAMA. 1993, 270 (16): 1962-1964. 10.1001/jama.270.16.1962.CrossRefPubMed
19.
go back to reference Chen LH, Baker SP, Li G: Drinking history and risk of fatal injury: comparison among specific injury causes. Accid Anal Prev. 2005, 37 (2): 245-251. 10.1016/j.aap.2004.09.001.CrossRefPubMed Chen LH, Baker SP, Li G: Drinking history and risk of fatal injury: comparison among specific injury causes. Accid Anal Prev. 2005, 37 (2): 245-251. 10.1016/j.aap.2004.09.001.CrossRefPubMed
20.
go back to reference Bijur PE, Trumble A, Harel Y, Overpeck MD, Jones D, Scheidt PC: Sports and recreation injuries in US children and adolescents. Archives of Pediatrics & Adolescent Medicine. 1995, 149 (9): 1009-1016.CrossRef Bijur PE, Trumble A, Harel Y, Overpeck MD, Jones D, Scheidt PC: Sports and recreation injuries in US children and adolescents. Archives of Pediatrics & Adolescent Medicine. 1995, 149 (9): 1009-1016.CrossRef
21.
go back to reference Paavola M, Vartiainen E, Haukkala A: Smoking, alcohol use, and physical activity: a 13-year longitudinal study ranging from adolescence into adulthood. J Adolesc Health. 2004, 35 (3): 238-244.CrossRefPubMed Paavola M, Vartiainen E, Haukkala A: Smoking, alcohol use, and physical activity: a 13-year longitudinal study ranging from adolescence into adulthood. J Adolesc Health. 2004, 35 (3): 238-244.CrossRefPubMed
22.
go back to reference Swahn MH, Donovan JE: Correlates and predictors of violent behavior among adolescent drinkers. Journal of Adolescent Health. 2004, 34 (6): 480-492.CrossRefPubMed Swahn MH, Donovan JE: Correlates and predictors of violent behavior among adolescent drinkers. Journal of Adolescent Health. 2004, 34 (6): 480-492.CrossRefPubMed
23.
go back to reference Costa FM, Jessor R, Turbin MS: Transition into adolescent problem drinking: the role of psychosocial risk and protective factors. J Stud Alcohol. 1999, 60 (4): 480-490.CrossRefPubMed Costa FM, Jessor R, Turbin MS: Transition into adolescent problem drinking: the role of psychosocial risk and protective factors. J Stud Alcohol. 1999, 60 (4): 480-490.CrossRefPubMed
25.
go back to reference Official Cause of Death Statistics. 2003, Helsinki 2003 , Statistics Finland Official Cause of Death Statistics. 2003, Helsinki 2003 , Statistics Finland
26.
go back to reference Kannus P, Parkkari J, Koskinen S, Niemi S, Palvanen M, Jarvinen M, Vuori I: Fall-induced injuries and deaths among older adults. Jama. 1999, 281 (20): 1895-1899. 10.1001/jama.281.20.1895.CrossRefPubMed Kannus P, Parkkari J, Koskinen S, Niemi S, Palvanen M, Jarvinen M, Vuori I: Fall-induced injuries and deaths among older adults. Jama. 1999, 281 (20): 1895-1899. 10.1001/jama.281.20.1895.CrossRefPubMed
27.
go back to reference Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000, 320 (7244): 1240-1243. 10.1136/bmj.320.7244.1240.CrossRefPubMedPubMedCentral Cole TJ, Bellizzi MC, Flegal KM, Dietz WH: Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000, 320 (7244): 1240-1243. 10.1136/bmj.320.7244.1240.CrossRefPubMedPubMedCentral
28.
go back to reference Mattila VM: Injuries and Their Risk Factors in Finnish Adolescents. School of Public Health. 2005, Tampere , University of Tampere, 120- Mattila VM: Injuries and Their Risk Factors in Finnish Adolescents. School of Public Health. 2005, Tampere , University of Tampere, 120-
29.
go back to reference Pietila AM, Rantakallio P, Laara E: Background factors predicting non-response in a health survey of northern Finnish young men. Scandinavian Journal of Social Medicine. 1995, 23 (2): 129-136.PubMed Pietila AM, Rantakallio P, Laara E: Background factors predicting non-response in a health survey of northern Finnish young men. Scandinavian Journal of Social Medicine. 1995, 23 (2): 129-136.PubMed
30.
go back to reference Mo F, Turner MC, Krewski D, Merrick J: Adolescent injuries in Canada: findings from the Canadian community health survey, 2000-2001. Int J Inj Contr Saf Promot. 2006, 13 (4): 235-244. 10.1080/17457300600935122.CrossRefPubMed Mo F, Turner MC, Krewski D, Merrick J: Adolescent injuries in Canada: findings from the Canadian community health survey, 2000-2001. Int J Inj Contr Saf Promot. 2006, 13 (4): 235-244. 10.1080/17457300600935122.CrossRefPubMed
31.
go back to reference Lunetta P, Penttila A, Sarna S: The role of alcohol in accident and violent deaths in Finland. Alcoholism: Clinical & Experimental Research. 2001, 25 (11): 1654-1661. 10.1111/j.1530-0277.2001.tb02172.x.CrossRef Lunetta P, Penttila A, Sarna S: The role of alcohol in accident and violent deaths in Finland. Alcoholism: Clinical & Experimental Research. 2001, 25 (11): 1654-1661. 10.1111/j.1530-0277.2001.tb02172.x.CrossRef
32.
go back to reference Hibell B, Andersson B, Ahlström S, Balakireva O, Bjarnasson T, Kokkevi A, Morgan M: The 1999 ESPAD Report. Alcohol and other drug use among students in 30 European countries. 2000, Stockholm , The Swedish Council for Information on Alcohol and Other Drugs (CAN), Council of Europe, Co-operation Group to Combat Drug Abuse and Illicit Trafficking in Drug (Pompidou Group) Hibell B, Andersson B, Ahlström S, Balakireva O, Bjarnasson T, Kokkevi A, Morgan M: The 1999 ESPAD Report. Alcohol and other drug use among students in 30 European countries. 2000, Stockholm , The Swedish Council for Information on Alcohol and Other Drugs (CAN), Council of Europe, Co-operation Group to Combat Drug Abuse and Illicit Trafficking in Drug (Pompidou Group)
33.
go back to reference Gentilello LM, Rivara FP, Donovan DM, Jurkovich GJ, Daranciang E, Dunn CW, Villaveces A, Copass M, Ries RR: Alcohol interventions in a trauma center as a means of reducing the risk of injury recurrence. Ann Surg. 1999, 230 (4): 473-80; discussion 480-3. 10.1097/00000658-199910000-00003.CrossRefPubMedPubMedCentral Gentilello LM, Rivara FP, Donovan DM, Jurkovich GJ, Daranciang E, Dunn CW, Villaveces A, Copass M, Ries RR: Alcohol interventions in a trauma center as a means of reducing the risk of injury recurrence. Ann Surg. 1999, 230 (4): 473-80; discussion 480-3. 10.1097/00000658-199910000-00003.CrossRefPubMedPubMedCentral
34.
go back to reference Parkkari J, Kannus P, Natri A, Lapinleimu I, Palvanen M, Heiskanen M, Vuori I, Jarvinen M: Active living and injury risk. Int J Sports Med. 2004, 25 (3): 209-216. 10.1055/s-2004-819935.CrossRefPubMed Parkkari J, Kannus P, Natri A, Lapinleimu I, Palvanen M, Heiskanen M, Vuori I, Jarvinen M: Active living and injury risk. Int J Sports Med. 2004, 25 (3): 209-216. 10.1055/s-2004-819935.CrossRefPubMed
Metadata
Title
Adolescents' health and health behaviour as predictors of injury death. A prospective cohort follow-up of 652,530 person-years
Authors
Ville M Mattila
Jari Parkkari
Leena Koivusilta
Tapio Nummi
Pekka Kannus
Arja Rimpelä
Publication date
01-12-2008
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2008
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-8-90

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