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Open Access 01-12-2019 | Research article

The influence of behavioural and socioeconomic factors on the community injury rates of adolescents assessed by the south Korean emergency medical services: an ecological approach

Authors: Ki Ok Ahn, Jungeun Kim, Sang Do Shin, Hyesook Park, Federico E. Vaca, Ju Ok Park

Published in: BMC Public Health | Issue 1/2019

Abstract

Background

Aim of this study is to determine if peer group risk behaviors and neighbourhood socioeconomic status (SES) would ecologically affect injury incidence according to place and gender among adolescents (aged 13–15) in South Korea.

Methods

Three variables from the Korea Youth Risk Behavior Survey (2014) were used to represent peer group risk behaviours; current alcohol consumption (cAlc), the experience of violence or bullying (VicVB), and having undergone education for injury prevention (Edu-IP). The Korea Census Data (2010) was used for neighborhood SES; the degree of urbanization, the proportion of high educational attainment, and the proportion of low residential environment. The nationwide and regional Incidence-Rates of Injury assessed by EMS (IRI-EMS) were calculated according to age and gender based on the number of injuries from EMS record (2014). A linear regression model was used to examine associations.

Results

The nationwide total and inside-school IRI-EMS were 623.8 and 139.3 per 100,000 population, respectively. The range of the regional IRI-EMS showed a maximum of about 4 times the difference from 345 to 1281 per 100,000 population depending on the region. The low residential environment had a significant effect on the increase of total IRI-EMS (β = 7.5, 95% CI 0.78–14.21). In the case of boys, the IRI-EMS inside-school was increased as the percentage of VicVB was higher (β = 17.0, 95% CI 1.09–32.91). In the case of girls, the IRI-EMS outside-school was increased in rural compared to urban location (β = 211.3, 95% CI 19.12–403.57).

Conclusion

The incidence rate of outside-school was higher than that of inside-school, and incidence rate of boys was higher than that of girls. Peer group risk behaviors were significant only in the injury of boys. Among the SES factors, rural area was a significant factor in girls, especially outside-school injury. Moreover, the rate of households not in an apartment was significant in all outside-school injury and outside-school injury of boys.

Our study suggests that among native South Korean adolescents, neighbourhood SES and peer group risk behavior have different effects depending on the injury context such as place of occurrence or gender.

Harvey A, Towner E, Peden M, Soori H, Bartolomeos K. Injury prevention and the attainment of child and adolescent health. Bull World Health Organ. 2009;87:390–4. https://doi.org/10.2471/BLT.08.059808.CrossRefPubMedPubMedCentral

Mokdad AH, Forouzanfar MH, Daoud F, Mokdad AA, El Bcheraoui C, Moradi-Lakeh M, et al. Global burden of diseases, injuries, and risk factors for young people’s health during 1990-2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2016;387:2383–401. https://doi.org/10.1016/S0140-6736(16)00648-6.CrossRefPubMed

Street EJ, Jacobsen KH. Injury incidence among middle school students aged 13-15 years in 47 low-income and middle-income countries. Inj Prev. 2016;22:432–6. https://doi.org/10.1136/injuryprev-2015-041786.CrossRefPubMed

Denny VC, Cassese JS, Jacobsen KH. Nonfatal injury incidence and risk factors among middle school students from four Polynesian countries: the Cook Islands, Niue, Samoa, and Tonga. Injury. 2016;47:1135–42. https://doi.org/10.1016/j.injury.2015.12.018.CrossRefPubMed

Cattelino E, Glowacz F, Born M, Testa S, Bina M, Calandri E. Adolescent risk behaviours and protective factors against peer influence. J Adolesc. 2014;37:1353–62. https://doi.org/10.1016/j.adolescence.2014.09.013.CrossRefPubMed

Phillips SP, King N, Michaelson V, Pickett W. Sex, drugs, risk and resilience: analysis of data from the Canadian health behaviour in school-aged children (HBSC) study. Eur J Pub Health. 2018;29:38–43. https://doi.org/10.1093/eurpub/cky169.CrossRef

Russell K, Davison C, King N, Pike I, Pickett W. Understanding clusters of risk factors across different environmental and social contexts for the prediction of injuries among Canadian youth. Injury. 2016;47:1143–50. https://doi.org/10.1016/j.injury.2015.11.030.CrossRefPubMed

Pickett W, Dostaler S, Craig W, Janssen I, Simpson K, Shelley SD, et al. Associations between risk behavior and injury and the protective roles of social environments: an analysis of 7235 Canadian school children. Inj Prev. 2006;12:87–92. https://doi.org/10.1136/ip.2005.011106.CrossRefPubMedPubMedCentral

Simpson K, Janssen I, Craig WM, Pickett W. Multilevel analysis of associations between socioeconomic status and injury among Canadian adolescents. J Epidemiol Community Health. 2005;59:1072–7. https://doi.org/10.1136/jech.2005.036723.CrossRefPubMedPubMedCentral

10.

Faelker T, Pickett W, Brison RJ. Socioeconomic differences in childhood injury: a population based epidemiologic study in Ontario. Canada Inj Prev. 2000;6:203–8.CrossRef

11.

McClure R, Kegler S, Davey T, Clay F. Contextual determinants of childhood injury: a systematic review of studies with multilevel analytic methods. Am J Public Health. 2015;105:e37–43. https://doi.org/10.2105/AJPH.2015.302883.CrossRefPubMedPubMedCentral

12.

Williams JM, Currie CE, Wright P, Elton RA, Beattie TF. Socioeconomic status and adolescent injuries. Soc Sci Med. 1997;44:1881–91.CrossRef

13.

Yuma-Guerrero P, Orsi R, Lee P-T, Cubbin C. A systematic review of socioeconomic status measurement in 13 years of U.S. injury research. J Saf Res. 2018;64:55–72. https://doi.org/10.1016/j.jsr.2017.12.017.CrossRef

14.

Pickett W, Molcho M, Simpson K, Janssen I, Kuntsche E, Mazur J, et al. Cross national study of injury and social determinants in adolescents. Inj Prev. 2005;11:213–8. https://doi.org/10.1136/ip.2004.007021.CrossRefPubMedPubMedCentral

15.

Pabayo R, Molnar BE, Kawachi I. The role of neighborhood income inequality in adolescent aggression and violence. J Adolesc Health. 2014;55:571–9. https://doi.org/10.1016/j.jadohealth.2014.04.012.CrossRefPubMed

16.

Linakis JG, Amanullah S, Mello MJ. Emergency department visits for injury in school-aged children in the United States: a comparison of nonfatal injuries occurring within and outside of the school environment. Acad Emerg Med. 2006;13:567–70. https://doi.org/10.1197/j.aem.2005.11.073.CrossRefPubMed

17.

Hong CH. Current health issues in Korean adolescents. Korean J Pediatr. 2011;54:395–400. https://doi.org/10.3345/kjp.2011.54.10.395.CrossRefPubMedPubMedCentral

18.

Kim Y, Choi S, Chun C, Park S, Khang Y-H, Oh K. Data resource profile: the Korea youth risk behavior web-based survey (KYRBS). Int J Epidemiol. 2016;45:1076–1076e. https://doi.org/10.1093/ije/dyw070.CrossRefPubMed

19.

Yu J-O, Kim M-S. Factors associated with unintentional injuries to Korean adolescents at school: a multilevel study. J Korean Acad Community Health Nurs. 2016;27:337. https://doi.org/10.12799/jkachn.2016.27.4.337.CrossRef

20.

KOSIS > Statistical Database. http://kosis.kr/eng/statisticsList/statisticsListIndex.do?menuId=M_01_01&vwcd=MT_ETITLE&parmTabId=M_01_01. Accessed 14 Apr 2018.

21.

The relationship between social class distribution and mortality. Korean Journal of Health Policy and Administration 2003;13:99–114. doi:https://doi.org/10.4332/KJHPA.2003.13.4.099.

22.

Cheong K-S, Choi M-H, Cho B-M, Yoon T-H, Kim C-H, Kim Y-M, et al. Suicide rate differences by sex, age, and urbanicity, and related regional factors in Korea. J Prev Med Public Health. 2012;45:70–7. https://doi.org/10.3961/jpmph.2012.45.2.70.CrossRefPubMedPubMedCentral

23.

Park HA, Ahn KO, Park JO, Kim J, Jeong S, Kim M. Epidemiologic characteristics of injured school-age patients transported via emergency medical Services in Korea. J Korean Med Sci. 2018;33:e73. https://doi.org/10.3346/jkms.2018.33.e73.CrossRefPubMedPubMedCentral

24.

Grant WB. A multicountry ecological study of cancer incidence rates in 2008 with respect to various risk-modifying factors. Nutrients. 2013;6:163–89. https://doi.org/10.3390/nu6010163.CrossRefPubMedPubMedCentral

25.

You W, Henneberg M. Prostate Cancer incidence is correlated to Total meat intake– a cross-National Ecologic Analysis of 172 countries. Asian Pac J Cancer Prev. 2018;19:2229–39. https://doi.org/10.22034/APJCP.2018.19.8.2229.CrossRefPubMedPubMedCentral

26.

Pulido Valero R, Martín Seoane G, Lucas Molina B. Risk profiles and peer violence in the context of school and leisure time. Span J Psychol. 2011;14:701–11.CrossRef

27.

Ranney ML, Whiteside L, Walton MA, Chermack ST, Zimmerman MA, Cunningham RM. Sex differences in characteristics of adolescents presenting to the emergency department with acute assault-related injury. Acad Emerg Med. 2011;18:1027–35. https://doi.org/10.1111/j.1553-2712.2011.01165.x.CrossRefPubMedPubMedCentral

28.

Walton MA, Cunningham RM, Goldstein AL, Chermack ST, Zimmerman MA, Bingham CR, et al. Rates and correlates of violent behaviors among adolescents treated in an urban emergency department. J Adolesc Health. 2009;45:77–83. https://doi.org/10.1016/j.jadohealth.2008.12.005.CrossRefPubMedPubMedCentral

29.

Bradshaw CP, Waasdorp TE, Goldweber A, Johnson SL. Bullies, gangs, drugs, and school: understanding the overlap and the role of ethnicity and urbanicity. J Youth Adolesc. 2013;42:220–34. https://doi.org/10.1007/s10964-012-9863-7.CrossRefPubMed

30.

Bradshaw CP, Sawyer AL, O’Brennan LM. A social disorganization perspective on bullying-related attitudes and behaviors: the influence of school context. Am J Community Psychol. 2009;43:204–20. https://doi.org/10.1007/s10464-009-9240-1.CrossRefPubMed

31.

Silva MAI, Pereira B, Mendonça D, Nunes B, de Oliveira WA. The involvement of girls and boys with bullying: an analysis of gender differences. Int J Environ Res Public Health. 2013;10:6820–31. https://doi.org/10.3390/ijerph10126820.CrossRefPubMedPubMedCentral

32.

Kim K, Ozegovic D, Voaklander DC. Differences in incidence of injury between rural and urban children in Canada and the USA: a systematic review. Inj Prev. 2012;18:264–71. https://doi.org/10.1136/injuryprev-2011-040306.CrossRefPubMed

33.

Myers SR, Branas CC, French BC, Nance ML, Kallan MJ, Wiebe DJ, et al. Safety in numbers: are major cities the safest places in the United States? Ann Emerg Med. 2013;62:408–418.e3. https://doi.org/10.1016/j.annemergmed.2013.05.030.CrossRefPubMedPubMedCentral

34.

Kmet L, Macarthur C. Urban-rural differences in motor vehicle crash fatality and hospitalization rates among children and youth. Accid Anal Prev. 2006;38:122–7. https://doi.org/10.1016/j.aap.2005.07.007.CrossRefPubMed

35.

Thouez JP, Joly MF, Rannou A, Bussière Y, Bourbeau R. Geographical variations of motor-vehicle injuries in Quebec, 1983-1988. Soc Sci Med. 1991;33:415–21.CrossRef

36.

Hwang HC, Stallones L, Keefe TJ. Childhood injury deaths: rural and urban differences, Colorado 1980-8. Inj Prev. 1997;3:35–7.CrossRef

37.

Mayes S, Roberts MC, Stough CO. Risk for household safety hazards: socioeconomic and sociodemographic factors. J Saf Res. 2014;51:87–92. https://doi.org/10.1016/j.jsr.2014.09.002.CrossRef

38.

Kroshus E, Kerr ZY, Lee JGL. Community-level inequalities in concussion education of youth football coaches. Am J Prev Med. 2017;52:476–82. https://doi.org/10.1016/j.amepre.2016.12.021.CrossRefPubMed

39.

Elo IT. Social class differentials in health and mortality: patterns and explanations in comparative perspective. Annu Rev Sociol. 2009;35:553–72. https://doi.org/10.1146/annurev-soc-070308-115929.CrossRef

40.

Schmidt S, Sparks PJ. Disparities in injury morbidity among young adults in the USA: individual and contextual determinants. J Epidemiol Community Health. 2018;72:458–64. https://doi.org/10.1136/jech-2017-210259.CrossRefPubMedPubMedCentral

Title: The influence of behavioural and socioeconomic factors on the community injury rates of adolescents assessed by the south Korean emergency medical services: an ecological approach
Authors: Ki Ok Ahn
Jungeun Kim
Sang Do Shin
Hyesook Park
Federico E. Vaca
Ju Ok Park
Publication date: 01-12-2019
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-019-7190-6

At a glance: The STEP trials

Springer Medicine

The influence of behavioural and socioeconomic factors on the community injury rates of adolescents assessed by the south Korean emergency medical services: an ecological approach

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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