Youth‘12 National Health and Wellbeing Survey
Theresa (Terry) Fleming, on behalf of &
The Adolescent Health Research Group
Risk of injury among
young New Zealenders
with disability and
long-term conditions with functional limitations
Roshini Peiris-John, Haya Al-Ani,
Terryann Clark, Theresa Flemming,
Janie Sheridan, Arier Lee,
Shanthi Ameratunga
Section of Epidemiology and Biostatistics,
School of Population Health
www.youthresearch.auckland.ac.nz
Background In New Zealand, one in four people identified as
disabled (Disability Survey 2013)
11% of children <15 years (n=95,000)
International research suggests people living with disabilities are known to:
experience poorer levels of health
not have equal access to healthcare
Have higher risk of injuries
Limited population-based information on injury risks among young New Zealanders with disabilities
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Aim To investigate the risk of injury and associated
healthcare interactions among adolescents living
with disabling conditions in New Zealand
International Classification of Functioning
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Method Youth’12 survey
National secondary school student survey
N=8,500 (response rate - 68%)
Self-administered questionnaire using touch screen tablets
Students responded to a broad range of questions including:
Socio-demographic information
Risk and protective factors in home, school and community
Health and healthcare interactions
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Method (cont.)
Disabling conditions defined as:
Any disability (lasting six months or more)
OR
Any health problem (lasting six months or more) with
functional limitations
Difficulty/ inability to carry out every day activities/
other activities that other people of the same age
could do
Difficulty/ inability communicate, mix or socialise
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Method (cont.)
Analysis
Data were weighted and the variance of
estimates adjusted.
Logistic regression models (controlling for
age, gender, ethnicity, home locale and
indicators of socioeconomic status)
investigated associations between disabling
condition and
risky behaviour related to road use
injury risk: injury requiring healthcare
cause of injury
problems seeking healthcare for injury
www.youthresearch.auckland.ac.nz
Youth‘12 National Health and Wellbeing Survey
Theresa (Terry) Fleming, on behalf of &
The Adolescent Health Research Group
Results Students with
disabling
conditions
(n=1,267) (15%)
Reference
population
(n=7,233)
(85%)
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Results (cont.) Demographic characteristics of study participants
Students with
disabling conditions Reference population Chi2
(p-value) n %(95%CI) n %(95%CI)
Age
<13 221 12.7(11.0-14.4) 1508 87.3(85.6-89.0)
14.571
(0.006)
14 282 15.4(13.9-17.0) 1541 84.6(83.0-86.1)
15 281 16.7(15.0-18.4) 1405 83.3(81.6-85.0)
16 257 16.8(14.4-19.3) 1259 83.1(80.7-85.6)
>17 225 16.3(14.0-18.6) 1154 83.7(81.4-86.0)
Gender
Male 530 14.3(13.1-15.5) 3168 85.7(84.5-86.9) 7.815
(0.005) Female 737 16.6(15.2-17.9) 3706 83.4(82.1-84.7)
Prioritised ethnicity
Maori 255 15.7(13.8-17.5) 1371 84.3(82.4-86.2)
32.706
(<0.001)
Pacific island 140 12.4(9.6-15.2) 994 87.6(84.8-90.4)
Asian 113 11.4(9.1-13.6) 883 88.6(86.4-90.8)
Other 82 16.9(13.1-20.6) 398 83.1(79.4-86.9)
European 676 17.3(16.1-18.4) 3221 82.7(81.6-83.9)
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Results (cont.)
Socioeconomic characteristics of study participants
Students with
disabling conditions Reference population Chi2
(p-value) n %(95%CI) n %(95%CI)
NZ deprivation1
Lower (Decile 1-3) 405 15.3(14.0-16.6) 2233 84.7(83.4-86.0) 0.952
(0.621)
Medium (Decile 4-7) 460 15.9(14.4-17.4) 2415 84.1(82.5-85.6)
Higher (Decile 8-10) 382 15.1(12.8-17.3) 2153 84.9(82.7-87.1)
Worry about not having enough money for food
Often/ all the time 211 24.0(20.5-27.6) 658 76.0(72.4-79.5) 56.111
(<0.001) Never/ occasionally 988 14.5(13.4-15.5) 5830 85.5(84.4-86.6)
Moved home
> twice 113 19.5(16.5-22.4) 472 80.5(77.6-83.4) 6.752
(0.009) <= twice 1153 15.2(14.2-16.3) 6396 84.8(83.7-85.8)
1NZ Deprivation index 2006
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Results (cont.)
*Adjusted for age, sex, prioritised ethnicity, worry often about food, moved frequently and NZDep2006 group
N (%)
Adjusted OR
(95%CI)* Students with
disabling
conditions
Reference
population
Risky behaviour related to road use Always wear a helmet while
cycling (among those who cycle) 347(37.0) 1709(34.0) 0.87 (0.75-1.01)
Always wear a seatbelt 915(72.3) 5118(74.6) 1.12 (0.94-1.35)
Risk taking as a driver Driving within two hours of taking
>two glasses of alcohol 27(4.2) 115(3.6) 1.03(0.62-1.70)
Driving when high on alcohol 26(4.1) 134(4.2) 0.87(0.54-1.39)
Driving dangerously 62(9.9) 317(10.0) 0.99 (0.70-1.41)
Risk taking as a passenger in a vehicle
Driver who was drinking alcohol 272(21.6) 1206(17.6) 1.16(0.96-1.39)
Driver was drunk/ taken drugs 151(11.9) 549(8.0) 1.32 (1.04-1.66)
Driver driving dangerously 394(23.4) 1124(16.4) 1.43 (1.23-1.66)
Risky behaviour related to road use
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N (%)
Adjusted OR
(95%CI)* Students with
disabling conditions
Reference
population
Accessed healthcare for
injury (previous 12 months) 807(63.9) 3767(55.0) 1.36 (1.22-1.51)
Causes of injury requiring healthcare
Road traffic crash 70(5.5) 215(3.1) 1.70(1.24-2.35)
Fall 311(24.5) 1187(17.2) 1.46(1.23-1.72)
Near drowning 21(1.7) 32(0.5) 3.24(1.83-5.74)
Work-related injury 36(2.8) 129(1.9) 1.36(0.98-1.91)
Sport or recreation-related
injury 517(41.0) 2582(37.7) 1.10(0.98-1.24)
Assault 53(4.2) 117(1.7) 2.42(1.67-3.52)
Attempted self-harm 87(6.9) 91(1.3) 4.89(3.48-6.86)
Difficulty in accessing
healthcare for injury 187(15.5) 700(10.8) 1.55(1.29-1.85)
Results (cont.)
*Adjusted for age, sex, prioritised ethnicity, worry often about food, moved frequently and NZDep2006 group
Healthcare utilisation for injury
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Adolescents with disabling conditions in New Zealand, attending
mainstream schools (cf. with their peers) are at greater odds of: being a passenger in a motor vehicle driven dangerously or
by someone who was drunk or taken drugs
intentional and unintentional injury
experience greater difficulty accessing healthcare for injury when needed
More work is needed to identify the physical and social barriers
that exist
The risks identified require particular attention of healthcare
providers, public health workers and policy makers
Conclusions
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Thank You
For more detailed information please see our website
www.youthresearch.auckland.ac.nz
The Youth’12 project was funded by the Ministries of Youth
Development, Social
Development, Health, Education
and Justice, the Department of Labour, the Families Commission
and the Health Promotion Agency
(HPA)
Thanks to all the schools and
students who participated
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