title: Structural Determinants of Youth Bullying and Fighting in 79 Countries.
abstract: OBJECTIVE
  The prevention of youth violence is a public health priority in many countries. We examined the prevalence of bullying victimization and physical fighting in youths in 79 high- and low-income countries and the relations between structural determinants of adolescent health (country wealth, income inequality, and government spending on education) and international differences in youth violence.
  
  
  METHODS
  Cross-sectional surveys were administered in schools between 2003 and 2011. These surveys provided national prevalence rates of bullying victimization (n = 334,736) and four or more episodes of physical fighting in the past year (n = 342,312) in eligible and consenting 11-16 year olds. Contextual measures included per capita income, income inequality, and government expenditures on education. We used meta-regression to examine relations between country characteristics and youth violence.
  
  
  RESULTS
  Approximately 30% of adolescents reported bullying victimization and 10.7% of males and 2.7% of females were involved in frequent physical fighting. More youth were exposed to violence in African and Eastern Mediterranean countries than in Europe and Asia. Violence directly related to country wealth; a 1 standard deviation increase in per capita income corresponded to less bullying (-3.9% in males and -4.2% in females) and less fighting (-2.9% in males and -1.0% in females). Income inequality and education spending modified the relation between country wealth and fighting; where inequality was high, country wealth related more closely to fighting if education spending was also high.
  
  
  CONCLUSIONS
  Country wealth is a robust determinant of youth violence. Fighting in affluent but economically unequal countries might be reduced through increased government spending on education.
authors.affiliation: Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada. Electronic address: frank.elgar@mcgill.ca.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Elgar
authors.affiliation: Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada.
authors.forename: Britt
authors.initials: B
authors.lastname: McKinnon
authors.affiliation: Department of Criminology, Bar Ilan University, Ramat Gan, Israel.
authors.forename: Sophie D
authors.initials: SD
authors.lastname: Walsh
authors.affiliation: Faculty of Education, Queen's University, Kingston, Ontario, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Freeman
authors.affiliation: Public Health Ontario, Toronto, Ontario, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: D Donnelly
authors.affiliation: Centre of Health Promotion and Education, University of Lisbon, Lisbon, Portugal.
authors.forename: Margarida Gaspar
authors.initials: MG
authors.lastname: de Matos
authors.affiliation: Institute for Health and Social Policy, McGill University, Montreal, Quebec, Canada.
authors.forename: Genevieve
authors.initials: G
authors.lastname: Gariepy
authors.affiliation: Child and Adolescent Health Research Unit, School of Medicine, University of St. Andrews, St. Andrews, Scotland.
authors.forename: Aixa Y
authors.initials: AY
authors.lastname: Aleman-Diaz
authors.affiliation: Department of Public Health Sciences, Queen's University, Kingston, Canada.
authors.forename: William
authors.initials: W
authors.lastname: Pickett
authors.affiliation: School of Health Sciences, National University of Ireland, Galway, Republic of Ireland.
authors.forename: Michal
authors.initials: M
authors.lastname: Molcho
authors.affiliation: Child and Adolescent Health Research Unit, School of Medicine, University of St. Andrews, St. Andrews, Scotland.
authors.forename: Candace
authors.initials: C
authors.lastname: Currie
mesh_terms: D000293:Adolescent; D058445:Bullying / Q000706:statistics & numerical data*; D002648:Child; D019548:Crime Victims; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D038622:Internationality; D008297:Male; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D014754:Violence / Q000191:economics / Q000706:statistics & numerical data*
keywords: Bullying; Global School-based Health Survey; Health Behaviour in School-aged Children; Income inequality; Physical fighting; Youth violence