Patterns of youth injury: a comparison across the northern territories and other parts of Canada
Jessica Byrnes1,2, Nathan King1, Penelope Hawe3,4, Paul Peters5,6, William Pickett1,2,7 and Colleen Davison1,2,7*
Injury is the leading cause of death for young people in Canada (1,2). For those living in the northern territories (Yukon, Nunavut, and the Northwest Territories), injury represents an even greater problem. The three territories combined have the highest overall unintentional injury mortality in the country (3). Injury occurrence in Canadian youth has been profiled (4,5); however, the injury experience of young people living in the northern territories has rarely been examined. The North presents a unique context for life in Canada. Northern communities tend to be smaller, more remote, and have populations with a large proportion of individuals identifying as First Nation, Inuit or Metis (6). There are challenges associated with food insecurity, health services and the provision of affordable housing (7–9), all possible risk factors for injury (10–12). Being male (5), an adolescent (1) and having low socio-economic status are all associated with increased injury risks (13,14). Although there are many behavioural risk factors associated with injury, excessive alcohol consumption and the use of motorized vehicles are two notable concerns in youth populations throughout Canada (15–18).
Previous studies have determined that the injury experiences of residents of the northern territories differ from those of Canadians as a whole. In addition to higher rates of hospitalizations and mortality, northerners experience a greater proportion of injuries due to self-inflicted harm, off-road vehicle use, being a pedestrian, fighting, assaults and maltreatment compared with southern regions of Canada (19). Few previous studies have focussed their efforts on individual and community exposures and injury experiences specific to northern youth populations, and very few have focussed on the positive assets that might exist in communities for injury prevention. The purpose of this study is to examine injury occurrence among northern youth and to compare injury patterns with those of youth from other parts of Canada. We profile both individual and community-level risk or protective factors for injury. This analysis provides novel evidence to support the development and targeting of specific injury prevention efforts.
METHODS
Description of data set and study population
To examine injury occurrence, data were taken for secondary analysis from the 2009/2010 (Cycle 6) Health Behaviour in School-aged Children (HBSC) study in Canada. The HBSC survey provides information on youth health behaviours and outcomes, and in 2009–2010, 26,078 youth aged 11–15 years participated (Table I). Of these, 3,942 students attended one of 80 schools located in the three northern territories, and were classified as “northern youth” for this study. The experiences of these students were compared with those from participating provinces. The data set provides information on demographic characteristics, risk behaviours and information for evaluation of injury experiences, including information on injury frequency, location, activity and severity. Community demographic characteristics such as population size and population demographic were determined from the census subdivision (CSD) level data in the 2006 census (Statistics Canada, 2006). Community road access was derived from geographic data and Google maps data (Google Maps and Earth Imagery, 2014).
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