title: Gender differences in injuries among rural youth.
abstract: OBJECTIVE
  This paper presents injury data from the first year of a three year longitudinal study of risk taking behaviors among adolescents.
  
  
  METHODS
  Study subjects were a cohort of 758 rural students from Maryland's Eastern Shore who were in the eighth grade in 1987.
  
  
  METHODS
  Students completed a 45 minute, self administered survey in which they reported numbers of injuries experienced in the past year, risk taking behaviors, anger expression, delinquency, alcohol and drug use, physical exercise, work experience, and level of parental supervision. In addition, students had their height and weight measurements taken by trained research staff and completed a self rating of pubertal development using Tanner drawings.
  
  
  RESULTS
  Slightly more than half (53.2%) of the boys and over one third (37.7%) of the girls reported experiencing one or more medically attended injuries during the last year. Poisson regression analyses were conducted to estimate the extent to which gender differences in injuries could be accounted for by adolescent behaviors. Gender effects became non-significant when adjustments were made for risk taking, school discipline problems, and exercise frequency. Gender differences in injuries were reduced but remained significant when substance use, employment, and anger were controlled. Poisson regression analyses were conducted separately for males and females to assess whether factors associated with injuries were similar across genders. For boys, risk taking, anger, and school discipline problems were significantly related to number of injuries. Boys with a low body mass index and late pubertal development (mean ratio 3.09), as well as those with high body mass index and early pubertal development (mean ratio 2.16), reported greater numbers of injuries than average boys. For girls, substance use, cruising, risk taking, anger, and exercise frequency were significantly associated with injuries. Girls with an early onset of menses reported, on average, twice the number of injuries than those who were on time. Girls with high body mass index who were late in their pubertal development reported, on average, five times more injuries than other girls.
  
  
  CONCLUSIONS
  Although gender is a significant risk factor for injuries, certain behaviors like risk taking, school related delinquency, and physical exercise partially explain the higher number of injuries among adolescent males in this study. For both males and females, indicators of pubertal and physical development are important factors to consider in studies of injuries during early adolescence.
authors.affiliation: Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland, USA.
authors.forename: C S
authors.initials: CS
authors.lastname: Alexander
authors.forename: M R
authors.initials: MR
authors.lastname: Somerfield
authors.forename: M E
authors.initials: ME
authors.lastname: Ensminger
authors.forename: Y J
authors.initials: YJ
authors.lastname: Kim
authors.forename: K E
authors.initials: KE
authors.lastname: Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001294:Attitude to Health; D002648:Child; D015331:Cohort Studies; D003625:Data Collection; D005260:Female; D015438:Health Behavior; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008396:Maryland / Q000453:epidemiology; D016012:Poisson Distribution; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012309:Risk-Taking; D012423:Rural Health / Q000706:statistics & numerical data*; D017678:Sex Distribution; D012959:Socioeconomic Factors; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology