title: Social environments and physical aggression among 21,107 students in the United States and Canada.
abstract: BACKGROUND
  Physical aggression is an important issue in North American populations. The importance of students' social environments in the occurrence of physical aggression requires focused study. In this study, reports of physical aggression were examined in relation to social environment factors among national samples of students from Canada and the United States.
  
  
  METHODS
  Students in grades 6-10 from the United States (n = 14,049) and Canada (n = 7058) who had participated in the Health Behaviour in School-aged Children Survey (HBSC) were studied. Rates of students' physical aggression were compared between the 2 countries. School, family, socioeconomic, and peer-related factors were considered as potential risk factors. A simple social environment risk score was developed using the US data and was subsequently tested in the Canadian sample.
  
  
  RESULTS
  Risks for physical aggression were consistently higher among United States versus Canadian students, but the magnitude of these differences was modest. The relative odds of physical aggression increased with reported environmental risk. To illustrate, US boys in grades 6-8 reporting the highest social environment risk score (5+) experienced a relative odds of physical aggression 4.02 (95% CI 2.7-5.9) times higher than those reporting the lowest score (adjusted OR for risk scores 0 through 5+ was 1.00, 1.19, 2.10, 2.01, 3.71, and 4.02, respectively, p(trend) < .001).
  
  
  CONCLUSIONS
  Unexpectedly, rates of physical aggression and associations between social environments and students' aggression were remarkably similar in Canada and the United States. Family, peer, and school social environments serve as risk or protective factors, with significant cumulative impact on physical aggression in both countries. Given the observed high rates and the many negative effects of aggression on long-term health, school policies aimed at the reduction of such behavior remain a clear priority.
authors.affiliation: Department of Community Health and Epidemiology, Emergency Medicine Research, Angada 3, Kingston General Hospital, 76 Stuart St, Kingston, Ontario K7L2V7, Canada. will.pickett@queensu.ca
authors.forename: William
authors.initials: W
authors.lastname: Pickett
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Iannotti
authors.forename: Bruce
authors.initials: B
authors.lastname: Simons-Morton
authors.forename: Suzanne
authors.initials: S
authors.lastname: Dostaler
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000378:Agonistic Behavior; D002170:Canada / Q000453:epidemiology; D002648:Child; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010379:Peer Group; D015995:Prevalence; D012737:Sex Factors; D012923:Social Class; D012944:Social Support; D013334:Students; D014481:United States / Q000453:epidemiology; D014754:Violence / Q000706:statistics & numerical data*