Injury is the leading cause of morbidity and mortality among Canadian youth. In order to develop successful prevention strategies for this major public health problem, it is necessary to determine injury risk factors. Despite reasons to believe that family structure (parents’ marital and living arrangements) may be associated with youth injury, this link has been largely overlooked in injury research. The objectives of this thesis were to determine whether family structure was associated with youth injury in a manner described by theory, after considering alternative explanations for the observed association and to explore how engaging in high risk behaviour mediated the impact of family structure on youth injury. The association was explored using cross-sectional and longitudinal data. This study was based on a representative, cross-sectional World Health Organization, Health Behaviour in School-aged Children (2006) survey of 9, 068 Canadian students, aged 11–15 years, from 186 schools. A sub-sample of 1, 885 Ontario students surveyed in 2006 and again in 2007 comprised the longitudinal sample. The associations were assessed using generalized estimating equations with classroom clusters and Poisson distribution, adjusting for identified potential confounders and examining mediation by high-risk behaviours.
There were three main findings: 1) Family structure was associated with medically treated injury in females, after accounting for confounding. Results showed that females from non-intact families had slightly increased risk of any injury than those from intact families (PR=1.11; 95% CI: 1.04-1.19). However, they had a greater risk of non-sports (PR=1.30; 95% CI: 1.16-1.77) and severe, non-sports (PR=1.46; 95% CI: 1.12-1.91) injury. 2) Only a small portion of the association between family structure and injury was explained by engaging in high risk behaviour. 3) There was an inconsistent relationship between family structure and male non-sports injury (Canadian cross-sectional, PR=1.05; 95% CI: 0.94-1.16; Ontario longitudinal, PR=1.58; 95% CI: 1.20-2.07). The findings of this thesis call attention to the importance of non-intact family structures as a risk factor for youth injury. More research is needed to improve our understanding of the mechanisms through which family structure influences youths' risk of injury in order to guide policy development.
| Identifer | oai:union.ndltd.org:TORONTO/oai:tspace.library.utoronto.ca:1807/19228 |
| Date | 03 March 2010 |
| Creators | Scott, Helen M. |
| Contributors | Chipman, Mary, Côté, Pierre |
| Source Sets | University of Toronto |
| Language | en_ca |
| Detected Language | English |
| Type | Thesis |
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