Trends and demographic characteristics of physical fighting and fighting-related injuries among Canadian youth, 1993-2010.

OBJECTIVES Physical fighting is a behaviour of concern that puts adolescents at increased risk for injury. The study objectives were to: 1) describe current patterns of physical fighting and fighting-related injury among Canadian adolescents, and 2) investigate potential trends in fighting and fighting-related injuries during the period 1993-2010. METHODS Canadian data from cycles 2-6 (1993-2010) of the Health Behaviour in School-aged Children (HBSC) study were used, giving cross-sections for 61,465 grade 6-10 students. Prevalence estimates for physical fighting and fighting-related injury were calculated and described by sex, grade and subjective social status. A trend analysis was conducted across time cycles overall and within subgroups. RESULTS A significant increase over time for physical fights was observed overall (ptrend = 0.015) and within female, grade 7-8, and high status subgroups, although further time points are necessary to determine this pattern with certainty. There was a significant trend increase over time for fighting-related injury overall and within all subgroups (ptrend < 0.001). Males were twice as likely as females to report a physical fight (p < 0.001) and fighting-related injury (p < 0.044). There was a significant decreased likelihood of physical fight involvement from lower to higher grades (p < 0.001), and an increased probability of fighting-related injury with increasing grades for three of five HBSC cycles. Subjective lower status was significantly associated with a higher likelihood of reporting a physical fight at all time points (p < 0.001) and fighting-related injury in three of five HBSC cycles. CONCLUSION Specific subgroups are more likely to report physical fight participation and sustaining a fighting injury. Understanding the context and trends of these outcomes is informative for public health interventions.