Injuries have been called “accidents” often inappropriately since they are sudden occurrences that appear to be unpredictable and uncontrollable. On close examination, however, injuries are often predictable and preventable and are not “accidents.” While being struck by a bolt of lighting may be termed a “freak accident,” the accident could likely have been prevented if the teen had sought appropriate shelter from the lightning.
In 1988, twenty-two and one half of adolescents age fourteen to seventeen years had at least one non-fatal injury, and these injuries were usually sports related. For younger children in the ten-to-thirteen-year-old age range, about one half of the injuries were sports related and the remainder were falls or cuts.
In 1992, of 1.7 million teens in the United States age fifteen to nineteen years, there were 4,818 deaths from motor vehicle accidents and 4,484 deaths from firearms. The death rate from motor vehicle accidents peaks for male adolescents around age twenty years, while it peaks for females at age fifteen years according to data from the National Center for Health Statistics. In 1999, motor vehicle accidents and firearm related injuries accounted for seventy-nine percent of deaths in adolescents age fifteen to nineteen.
Adolescents are at a very high risk for fatal and non-fatal injuries. In 2002, more than five thousand adolescents were killed in motor vehicle accidents in the U.S. and approximately 482,000 were injured. As a result of the high number of fatalities, in 2006 the legislature in Massachusetts was considering raising the minimum driving age to seventeen and one half years because of excessive injuries and fatalities in teenaged drivers.
Adolescent injuries may result from individual issues and problems within the family unit. In addition, problems with community and society including poverty, violence and war may be other factors that place certain adolescents at higher risk for injuries.
Teens who have Attention Deficit Disorder (ADD) are at higher risk for injury. Studies have shown that boys with ADD are more likely to be injured while riding a bicycle or as a pedestrian or inflict injury upon themselves. Also, teens that are “oppositional” have been shown to be at higher risk for injury. Stressful life events for an individual teen including death or illness of a relative, school failure or suspension or breaking up with a partner are associated with increased risk for injury in teens age thirteen to nineteen years. The use of substances especially alcohol is significantly related to injury in teens. Studies in older adolescents demonstrate that seriously injured teens admitted to a trauma center often use substances especially alcohol. And other studies have shown that suicidal behavior in teens is often related to increased use of substances including alcohol. Conflicts over independence and rebellion may lead to violence and injuries to certain adolescents.
Teens who are raised in chaotic and disorganized family units are at higher risk for injury. This includes not only physical or sexual abuse, but also psychological abuse and neglect. There is likely to be increased use of substances in these families with teens frequently becoming involved themselves with substances. Also, parental depression and health problems have been associated with violence toward adolescents.
Issues associated with poverty including problems with education, employment, parenting, housing and basic life needs, place adolescents at higher risk for substance use and other risky behaviors. This leads them to a higher risk for injury.
Non-fatal injuries may have very significant implications for teens. For example, a facial injury could lead to facial disfigurement. Physical attractiveness often correlates with popularity among adolescents. Therefore, a disfiguring facial injury could lead to problems with self-esteem, social interaction, dating, coping and academic success. Significant injuries may lead to posttraumatic stress disorder (PTSD). PTSD and preoccupation with the injury and the events around the injury may interfere with social integration and learning at school.
Many injuries are not “accidents.” Some authorities feel that injury prevention can be organized into engineering, enforcement, education and economic themes. For example, a seventeen-year-old alcohol intoxicated male not wearing a seatbelt has an “accident” sustaining an injury after rear-ending another automobile. Good engineering prevented his death after the airbag deployed. While enforcement did not prevent this accident, he will lose his driver’s license after a drunken driving conviction. Mandatory traffic education classes including sessions on alcohol abuse will be an initial push into reducing this teen’s incentive to drink and drive. And increasing automobile insurance premiums may prevent him from purchasing another car.
Injuries from firearms are usually not “accidents” either. Primary prevention of the “accidents” can take the same 4 E approaches. Firearms may be engineered so that only the owner can unlock or fire them. Laws can be enforced so that illegal firearm sales will be reduced. Teens could be universally required to pass firearm education classes before being allowed to handle firearms. And the tax on certain firearms could be increased to decrease the ability of adults to purchase them.
There is another way to look at prevention of firearm injuries. In the primary prevention of firearm injuries, a family may consider not allowing pre-adolescent children access to realistic appearing toy guns. Toy pistols may incent certain pre-adolescents to use real pistols when they are accessible. And on occasion, a child or adolescent has been inadvertently shot by a police officer when seen with a realistic appearing toy pistol. In secondary prevention, there is an effort to reduce the amount of firearms in a community. This may be done by confiscation of weapons using metal detectors at school, or a buy-back program. Clinicians can ask adults in teens’ families to keep their guns unloaded, locked and secure from their teenage children.
There are other strategies that can be utilized to reduce adolescent injuries:
Type of Injury Prevention Strategies
- Suicide Hotlines, low barrier access to counseling and mental health resources
- Motor Vehicle Driver education, licensing regulations
- Violence Children in need of services laws, hot lines, counseling
- Bicycle Low cost helmets, good lighting, bicycle trails
- Alcohol Strict enforcement of laws, regulation of advertisement aimed at teens, alcohol taxes
There also is a role for the mass media in the contribution to adolescent injuries. There is little controversy that higher levels of viewed violence in mass media correlate with an increased acceptance of aggressive attitudes and aggressive behaviors among adolescents. Of course, this may lead to injury. Media also play the role of the “super peer” which may have significant negative effects on adolescent behaviors. In some situations, media coverage of a suicide has led to copycat suicides over the short term in a particular geographical area. And there is little debate that positive media depictions of young adults drinking alcohol may influence teens to drink.
Media have a significant role in the prevention of injury. For example, the industry could eliminate the use of celebrities in selling alcoholic products or refuse to depict activities that are dangerous when one is under the influence. Positive role models may be shown refusing to drink and drive in media presentations including commercials, television and cinema. And media may run preventive public service announcements on a menu of topics including suicide, alcohol and firearms.
Related topics:
Academics, alcohol, alcoholism in a parent, attention deficit disorder, automobile safety, bicycle safety, child abuse and domestic violence, counseling, deaths, fire safety, fireworks injuries, independence and rebellion, movies, TV and computer games, posttraumatic stress disorder, risk-taking, self-esteem, suicide, violence and aggression
