Original ResearchGender differences in adolescent injury characteristics: A population-based study of hospital A&E data
Introduction
It is well documented that from the age of 1–2 onwards, reported injury rates are higher for boys than girls1, 2, 3, 4, 5, 6, 7 and that this continues through adulthood and into old age.8 There is also clear evidence that adolescence is a period of heightened vulnerability to injury1, 5, 9, 10, 11, 12, 13, 14, 15 and that the gap between boys’ and girls’ injury risk widens during this period of life.7, 11, 12, 16 However, despite the clear evidence for a male excess in injury risk, the reasons for this are less well understood. Various theories have been suggested.
There is evidence that boys are more active than girls17, 18 and it has been suggested that the male excess in injury rates is, at least in part, attributable to this.19
An alternative theory is that boys are at greater risk of injury because they perceive risk differently and are more likely to engage in risk-taking behaviour than girls.19 There is evidence for a biological basis for male risk-taking behaviour from both human and primate studies.20 There is also evidence that boys and girls are differently socialized20, 21 which could result in gender differences in risk perception and behaviour.20, 22 It may be that socialization processes shape gender differences in injury–risk perception and behaviour but that this takes place on a foundation of biological differences.20
The overall objective of this research project was to use an existing data set to investigate patterns of adolescent home/leisure injury serious enough to require hospital attendance. Specifically, the project sought to answer the following questions:
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Does the gender gap in injury risk widen during the teenage years in this population?
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If so, can this data set be used to quantify and describe the male excess in injury risk in order to inform prevention strategies?
Section snippets
Methods
The Home and Leisure Accident Surveillance System (HASS/LASS) was set up by the Department of Trade and Industry (DTI) to collect data on home and leisure accidents throughout the UK. Road traffic accidents, occupational accidents and intentional injuries were excluded. Data were coded into more than 50 fields, describing the accident, the injured person, the outcome, the injury and any article involved.23 Until it was discontinued in 2003, data collection took place in a nationally
Injury rates by age and sex
Table 1 shows A&E attendance, fracture and hospital admission rates and M:F RRRs for all injuries, sports injuries and non-sports injuries by age band.
The distribution of A&E attendance rates by year of age was bimodal, with the major peak at age 1 year and a second peak at age 12 years (see Fig. 1). Although A&E attendance rates for boys and girls followed a similar pattern, boys had higher rates of attendance at every age and the M:F RRR increased significantly with age (see Table 1).
Male and
Discussion
These data were collected as part of a large, well-established national system, which ensured a high degree of data quality. Although HASS/LASS was not designed for local, population-based analysis, this project demonstrates that with careful attention to identifying a target population, the data can be used successfully for this purpose. The system dictated that data collection was restricted to a single hospital but because this is not a large urban conglomeration with a choice of easily
Acknowledgments
The authors would like to acknowledge the contributions of the following: Dr Neil Hamlet; Professor David Stone, University of Glasgow; Hazel Towers and Derek Roseburgh of NHS Lanarkshire; Paul Clark from Monklands Hospital; Alistair Stewart from Lanarkshire Acute Hospitals NHS Trust and Lesley Mann from North Lanarkshire Council.
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