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

Morbidity and Mortality Weekly Report, Oct 16, 1992

Editorial Note: The findings in this report can be used to plan and evaluate broad national, state, and local interventions for injury prevention and to monitor progress toward achieving national health objectives for the year 2000 (objectives 6.2, 7.8, 7.9, 7.10, 9.12, and 9.13) (3). However, because the quality of the samples varied among the state and local surveys, data across sites may not be comparable.

Objectives 6.2 and 7.8 are to reduce by 15% the incidence of injurious suicide attempts that required medical attention among adolescents aged 14-17 years. Based on results from the 1991 national YRBS, the annual prevalence of injurious suicide attempts will need to be reduced from 2.0% to 1.4% by the year 2000 to meet the objectives. Only two sites have met these objectives. Objective 7.9 is to reduce by 20% the incidence of physical fighting among adolescents aged 14-17 years; based on the 1991 national YRBS, the 12-month incidence must decline from 137 to 110 or fewer episodes per 100 students by the year 2000. Only one site has met this objective.

Objective 7.10 is to reduce by 20% the incidence of weapon-carrying by adolescents aged 14-17 years. To meet this objective by the year 2000, the 30-day incidence rate must be reduced from 107 to 86 or fewer episodes per 100 students. Six sites have met this objective. Objective 9.12 is to increase to at least 85% the proportion of motor-vehicle occupants who use occupant-protection systems, and objective 9.13 is to increase use of helmets to at least 80% among motorcyclists and at least 50% among bicyclists. In all 33 sites, the prevalence of safety-belt, motorcycle-helmet, and bicycle-helmet use is substantially below these objectives.

Comprehensive health education programs in elementary, middle, and secondary schools may help meet the national health objectives. These programs should include information about the warning signs of suicide and suicide-prevention services, teach nonviolent conflict-resolution skills, discourage physical fighting and weapon carrying, and promote the use of safety belts and helmets to prevent motor-vehicle injuries (3). Other strategies that have been employed in the school setting to reduce weapon-carrying are random locker searchers, walk-throughs with metal detectors, and policies requiring clear plastic or mesh book bags so that weapons cannot be concealed easily (4). [TABULAR DATA OMITTED]

Complementary educational and legal strategies are needed at the community level, including decreasing the cultural acceptance of violence (5); decreasing aggressive behavior between parents and children (6); reducing the exposure of children and adolescents to violence in the media (7); and improving the recognition of children and adolescents at high risk for assaults (5). Gatekeeper training and screening programs can help identify youth at risk for suicide and refer them to mental health services (8).

Legislation that requires safety-belt and helmet use among adolescents and adults is needed in every state (3). National health objective 9.14 calls for the enactment and enforcement of laws requiring safety-belt and helmet use for persons of all ages. Increasing the use of safety belts, the use of motorcycle and bicycle helmets, and the practice of other safety precautions among adolescents will require cooperative efforts by local and state health, traffic-safety, and education officials; families; medical practitioners; retailers; community agencies serving youth; and legislators. [TABULAR DATA OMITTED]