youth‘12 national risk of injury among health and ... · risky behaviour related to road use...

Youth‘12 National Health and Wellbeing Survey

Theresa (Terry) Fleming, on behalf of &

The Adolescent Health Research Group

Risk of injury among

young New Zealenders

with disability and

long-term conditions with functional limitations

Roshini Peiris-John, Haya Al-Ani,

Terryann Clark, Theresa Flemming,

Janie Sheridan, Arier Lee,

Shanthi Ameratunga

Section of Epidemiology and Biostatistics,

School of Population Health

www.youthresearch.auckland.ac.nz

Background In New Zealand, one in four people identified as

disabled (Disability Survey 2013)

11% of children <15 years (n=95,000)

International research suggests people living with disabilities are known to:

experience poorer levels of health

not have equal access to healthcare

Have higher risk of injuries

Limited population-based information on injury risks among young New Zealanders with disabilities


Aim To investigate the risk of injury and associated

healthcare interactions among adolescents living

with disabling conditions in New Zealand

International Classification of Functioning


Method Youth’12 survey

National secondary school student survey

N=8,500 (response rate - 68%)

Self-administered questionnaire using touch screen tablets

Students responded to a broad range of questions including:

Socio-demographic information

Risk and protective factors in home, school and community

Health and healthcare interactions


Method (cont.)

Disabling conditions defined as:

Any disability (lasting six months or more)

OR

Any health problem (lasting six months or more) with

functional limitations

Difficulty/ inability to carry out every day activities/

other activities that other people of the same age

could do

Difficulty/ inability communicate, mix or socialise


Method (cont.)

Analysis

Data were weighted and the variance of

estimates adjusted.

Logistic regression models (controlling for

age, gender, ethnicity, home locale and

indicators of socioeconomic status)

investigated associations between disabling

condition and

risky behaviour related to road use

injury risk: injury requiring healthcare

cause of injury

problems seeking healthcare for injury


Youth‘12 National Health and Wellbeing Survey

Theresa (Terry) Fleming, on behalf of &

The Adolescent Health Research Group

Results Students with

disabling

conditions

(n=1,267) (15%)

Reference

population

(n=7,233)

(85%)


Results (cont.) Demographic characteristics of study participants

Students with

disabling conditions Reference population Chi2

(p-value) n %(95%CI) n %(95%CI)

Age

<13 221 12.7(11.0-14.4) 1508 87.3(85.6-89.0)

14.571

(0.006)

14 282 15.4(13.9-17.0) 1541 84.6(83.0-86.1)

15 281 16.7(15.0-18.4) 1405 83.3(81.6-85.0)

16 257 16.8(14.4-19.3) 1259 83.1(80.7-85.6)

>17 225 16.3(14.0-18.6) 1154 83.7(81.4-86.0)

Gender

Male 530 14.3(13.1-15.5) 3168 85.7(84.5-86.9) 7.815

(0.005) Female 737 16.6(15.2-17.9) 3706 83.4(82.1-84.7)

Prioritised ethnicity

Maori 255 15.7(13.8-17.5) 1371 84.3(82.4-86.2)

32.706

(<0.001)

Pacific island 140 12.4(9.6-15.2) 994 87.6(84.8-90.4)

Asian 113 11.4(9.1-13.6) 883 88.6(86.4-90.8)

Other 82 16.9(13.1-20.6) 398 83.1(79.4-86.9)

European 676 17.3(16.1-18.4) 3221 82.7(81.6-83.9)


Results (cont.)

Socioeconomic characteristics of study participants

Students with

disabling conditions Reference population Chi2

(p-value) n %(95%CI) n %(95%CI)

NZ deprivation1

Lower (Decile 1-3) 405 15.3(14.0-16.6) 2233 84.7(83.4-86.0) 0.952

(0.621)

Medium (Decile 4-7) 460 15.9(14.4-17.4) 2415 84.1(82.5-85.6)

Higher (Decile 8-10) 382 15.1(12.8-17.3) 2153 84.9(82.7-87.1)

Worry about not having enough money for food

Often/ all the time 211 24.0(20.5-27.6) 658 76.0(72.4-79.5) 56.111

(<0.001) Never/ occasionally 988 14.5(13.4-15.5) 5830 85.5(84.4-86.6)

Moved home

> twice 113 19.5(16.5-22.4) 472 80.5(77.6-83.4) 6.752

(0.009) <= twice 1153 15.2(14.2-16.3) 6396 84.8(83.7-85.8)

1NZ Deprivation index 2006


Results (cont.)

*Adjusted for age, sex, prioritised ethnicity, worry often about food, moved frequently and NZDep2006 group

N (%)

Adjusted OR

(95%CI)* Students with

disabling

conditions

Reference

population

Risky behaviour related to road use Always wear a helmet while

cycling (among those who cycle) 347(37.0) 1709(34.0) 0.87 (0.75-1.01)

Always wear a seatbelt 915(72.3) 5118(74.6) 1.12 (0.94-1.35)

Risk taking as a driver Driving within two hours of taking

>two glasses of alcohol 27(4.2) 115(3.6) 1.03(0.62-1.70)

Driving when high on alcohol 26(4.1) 134(4.2) 0.87(0.54-1.39)

Driving dangerously 62(9.9) 317(10.0) 0.99 (0.70-1.41)

Risk taking as a passenger in a vehicle

Driver who was drinking alcohol 272(21.6) 1206(17.6) 1.16(0.96-1.39)

Driver was drunk/ taken drugs 151(11.9) 549(8.0) 1.32 (1.04-1.66)

Driver driving dangerously 394(23.4) 1124(16.4) 1.43 (1.23-1.66)

Risky behaviour related to road use


N (%)

Adjusted OR

(95%CI)* Students with

disabling conditions

Reference

population

Accessed healthcare for

injury (previous 12 months) 807(63.9) 3767(55.0) 1.36 (1.22-1.51)

Causes of injury requiring healthcare

Road traffic crash 70(5.5) 215(3.1) 1.70(1.24-2.35)

Fall 311(24.5) 1187(17.2) 1.46(1.23-1.72)

Near drowning 21(1.7) 32(0.5) 3.24(1.83-5.74)

Work-related injury 36(2.8) 129(1.9) 1.36(0.98-1.91)

Sport or recreation-related

injury 517(41.0) 2582(37.7) 1.10(0.98-1.24)

Assault 53(4.2) 117(1.7) 2.42(1.67-3.52)

Attempted self-harm 87(6.9) 91(1.3) 4.89(3.48-6.86)

Difficulty in accessing

healthcare for injury 187(15.5) 700(10.8) 1.55(1.29-1.85)

Results (cont.)

*Adjusted for age, sex, prioritised ethnicity, worry often about food, moved frequently and NZDep2006 group

Healthcare utilisation for injury


Adolescents with disabling conditions in New Zealand, attending

mainstream schools (cf. with their peers) are at greater odds of: being a passenger in a motor vehicle driven dangerously or

by someone who was drunk or taken drugs

intentional and unintentional injury

experience greater difficulty accessing healthcare for injury when needed

More work is needed to identify the physical and social barriers

that exist

The risks identified require particular attention of healthcare

providers, public health workers and policy makers

Conclusions


Thank You

For more detailed information please see our website


The Youth’12 project was funded by the Ministries of Youth

Development, Social

Development, Health, Education

and Justice, the Department of Labour, the Families Commission

and the Health Promotion Agency

(HPA)

Thanks to all the schools and

students who participated


youth‘12 national risk of injury among health and ... · risky behaviour related to road use...

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