Behaviors related to unintentional and intentional injuries among high school students - United States, 1991

Morbidity and Mortality Weekly Report, Oct 16, 1992

During 1988, injuries were the leading cause of death among persons aged 15-19 years in the United States (CDC, unpublished data, 1988). Of all deaths in this age group, 42% were motor-vehicle related, 13% were due to homicide, 13% to suicide, and 11% to other types of injuries and adverse effects. This report presents 1991 self-reported data on the prevalence of selected behaviors (i.e., attempted suicide, physical fighting, weapon-carrying, safety-belt use, motorcycle-helmet use, and bicycle-helmet use) associated with these causes of death among 9th-12th-grade students in the United States.

Data were collected from two school-based components of CDC's Youth Risk Behavior Surveillance System (1): 1) state and local Youth Risk Behavior Surveys (YRBSs) conducted by departments of education in 23 states(*1) and 10 cities during the spring of 1991 and 2) the national YRBS conducted during the same period. The 33 state and local sites drew probability samples from defined sampling frames of schools and students in grades 9-12. Seventeen sites had adequate school- and student-response rates, which allowed computation of weighted results of known precision; 16 sites had overall response rates below 60% or unavailable documentation, which precluded making estimates of known precision. The national survey used a three-stage sample design to obtain a sample of 12,272 students representative of students in grades 9-12 in the 50 states and the District of Columbia.

For the state and local surveys, school-response rates ranged from 48% to 100%; student-response rates ranged from 44% to 96% (2); and state and local sample sizes ranged from 369 to 5834 students. Students in most samples were distributed evenly across grades and between sexes, and the racial/ethnic characteristics of the samples varied. The school-response rate for the national survey was 75%, and the student-response rate was 90%.

Suicide Attempts

Of students participating in the state and local surveys, 14%-35% (median: 27%; national prevalence: 29%) had thought seriously about attempting suicide, 9%-22% (median: 17%; national prevalence: 19%) had made a specific plan to attempt suicide, 5%-12% (median: 8%; national prevalence: 7%) actually attempted suicide, and 1%-5% (median: 2%; national prevalence: 2%) made a suicide attempt that resulted in an injury or poisoning that had to be treated by a doctor or nurse (Table 1). In all sites, female students were more likely than male students to report having thought seriously about attempting suicide, made a suicide plan, attempted suicide one or more times, and made a suicide attempt that required medical attention.

Physical Fighting and Weapon-Carrying

Of students participating in the state and local surveys, 34%-56% (median: 42%; national prevalence: 42%) had been in at least one physical fight during the 12 months preceding the survey (Table 2). In every site, male students were more likely than female students to report having been in a physical fight. The 12-month incidence rate[unkeyable] for physical fighting ranged from 102 incidents per 100 students to 202 incidents per 100 students (median: 140; national incidence: 137 per 100 students).

Of participating students, 16%-39% (median: 26%; national prevalence: 26%) carried a weapon such as a gun, knife, or club at least 1 day during the 30 days preceding the survey; among students who carried a weapon, 5%-41% (median: 11%; national prevalence: 11%) most often carried a handgun (Table 2). In every site, male students were more likely than female students to have carried a weapon. The 30-day incidence rate[unkeyable] for weapon-carrying ranged from 62 to 164 incidents per 100 students (median: 110; national incidence: 107 per 100 students).

Safety-Belt and Helmet Use

Of students participating in the state and local surveys, 7%-54% (median: 22%; national prevalence: 28%) "always" used safety belts when riding in a car or truck driven by someone else (Table 3, page 771). Among students who rode motorcycles, 10%-59% (median: 36%; national prevalence: 39%) "always" wore motorcycle helmets. Among students who rode bicycles, 0.2%-3% (median: 1%; national prevalence: 1%) "always" wore bicycle helmets. Rates of safety-belt, motorcycle-helmet, and bicycle-helmet use were similar for female and male students in most sites.

Reported by: J Moore, EdD, Alabama State Dept of Education. J Campana, MA, San Diego Unified School District; M Lam, MSW, San Francisco Unified School District. D Sandau-Christopher, State of Colorado Dept of Education. J Sadler, MPH, District of Columbia Public Schools. D Scalise, MS, School Board of Broward County; N Gay, MSW, School Board of Dade County, Florida. R Stalvey, MS, Georgia Dept of Education. J Schroeder, Hawaii Dept of Education. J Pelton, PhD, Idaho Dept of Education. B Johnson Biehr, MS, Chicago Public Schools. J Harris, MEd, Iowa Dept of Education. N Strunk, MS, Boston Public Schools. R Chiotti, Montana Office of Public Instruction. J Owens-Nausler, PhD, Nebraska Dept of Education. B Grenert, MEd, New Hampshire State Dept of Education. D Chioda, MS, Jersey City Board of Education; D Cole, MEd, New Jersey State Dept of Education. K Meurer, MS, New Mexico State Dept of Education. G Abelson, CSW, New York City Board of Education; A Sheffield, MPH, New York State Education Dept. P Ruzicka, PhD, Oregon Dept of Education. C Balsley, EdD, School District of Philadelphia; M Sutter, PhD, Pennsylvania Dept of Education. M del Pilar Cherneco, MPH, Puerto Rico Dept of Education. J Fraser, EdD, South Carolina State Dept of Education. M Carr, MS, South Dakota Dept of Education and Cultural Affairs. E Word, MA, Tennessee State Dept of Education. P Simpson, PhD, Dallas Independent School District. L Lacy, MS, Utah State Office of Education. S Tye, PhD, Government of the Virgin Islands Dept of Education. B Nehls-Lowe, MPH, Wisconsin Dept of Public Instruction. B Anderson, Wyoming Dept of Education. National Center for Injury Prevention and Control; Div of Adolescent and School Health, National Center for Chronic Disease Prevention and Health Promotion, CDC.