Behavior and injury in urban and rural adolescents

Objectives - This study investigates the consistency of factors associated with adolescent injury in separate urban and rural samples. Samples - Adolescents, 11-17 years old, in public schools in urban and rural Maryland (n = 2712). Methods - Separate bivariate and logistic regression analyses were conducted for each sample to determine individual and environmental factors associated with major and minor injuries experienced in the previous year. Results - Multivariate analyses revealed that, for both samples, the probability of a major injury was highest for boys and, among both boys and girls, for those who played several team sports. Among rural youth, other significant covariates of both major and minor injuries were a tendency to engage in risky behavior and to use alcohol. For urban youth, being white, carrying a weapon for protection, attending an unsafe school, and working for pay were also significant covariates. Interactions were important and complex. Conclusions - The consistency of predictive factors, such as multiple sports team participation and risky and aggressive behaviors in completely different physical environments, underscores the need to address the contexts of heightened injury risk that some adolescents create wherever they live by playing sports and/ or behaving in an antisocial, aggressive manner. Moreover, the perception of lack of safety in schools and neighborhoods is associated with increased injury rates, suggesting the need for policy interventions to target social environments as well as behavior.