Injury is the leading cause of death and disability in young people in Australia. Young people are over-represented in injury statistics compared with any other age group.
The consequences of injury are life-long – youth injury has a major impact on the short and long-term health of individuals and their families as well as creating a huge burden on the Australian health system.
WHY IS YOUTH INJURY A CONCERN?
- In Australia, injury and poisoning is the leading cause of death and hospitalisation among young people, yet many injuries are preventable (AIHW 2011).
- In 2011-12, just over 130,000 Australian children and young people (aged 0-24 years) were hospitalised as a result of an injury, with boys outnumbering girls two to one (AIHW 2014).
- Annually, hospital treatments of children aged between 0-16 cost an estimated $212 million, with a mean cost per injury child of $3,119 (Mitchell, Curtis & Foster 2017).
- In Australia, injuries to young workers aged 15 to 24 cost $5,800 million, which is approximately $143,700 per case (SafeWork Australia 2017).
- The economic cost of road trauma in Australia is $22.2 billion – the cost per fatality is $4.34 million and cost per injury is $239,000 (AAA, 2017). With more than 1,600 young drivers aged from 15 to 24 years having died on Australian roads in the past five years (TfNSW Centre for Road Safety 2015), the economic costs to the community are significant.
WHY IS THERE AN INCREASED RISK OF INJURY IN YOUNG PEOPLE?
There are a number of factors which combine to put young people at greater risk of injury than other age groups. Risks associated with being young include:
- New levels of independence – young people generally start being more mobile during adolescence and have less adult supervision.
- Inexperience with new situations, which may require developing new skills, such as driving.
- Desire for experimentation and thrill seeking which includes inexperience with alcohol and experimentation with alcohol and drugs.
- Risk taking tendencies – thrill seeking behaviours are part of normal adolescent development.
- Still developing maturity, hazard perception and decision making skills – the area of the brain related to these functions is generally continuing to develop in young people into their 20s.
- Strong influence of peers – at no time is the influence of peers greater than it is in adolescence. We know that young people are often motivated by the short term gain of impressing their mates and peer acceptance rather than the longer term concerns of health and safety.
- Overconfidence in own ability and a sense of invulnerability. As a result, they are more likely to take dangerous risks.
Young people of low socio-economic status
- Research indicates there is a strong link between socio-economic status (SES) and injury risk across all age groups. The rates of hospitalised injury are highest for those living in the most disadvantaged areas of Australia, and conversely the rates are the lowest for those who live in the most advantaged areas (AIHW 2019).
- A ‘social gradient of health view’ for injury, that is the higher people’s incomes and education, the healthier they are and at the lower risk of injury, was the strongest in the 15 to 24 age group. “For each subsequent decrease in socioeconomic status, there was a corresponding increase in the proportion of hospitalised injury cases” (AIHW 2019: 7).
- Injuries due to transport related crashes were highest for young people aged 15 to 24 in the lowest socio-economic group, compared to their counterparts in the highest socio-economic group (AIHW 2019).
- There are a range of factors that increase the risk of workplace injury for young workers, including socioeconomic status and minority status (Okun et al 2016).
Young people living far from big cities
- The injury death rate for residents living in Remote areas was more than 2 times the rate for residents of Major Cities (AIHW 2018).
- The further you live from a major metropolitan centre, the greater your risk of injury: the injury death rate for young people in Very Remote areas was almost 5 times those in Major Cities, and the hospitalisation rate was 3 times as high (AIHW: Eldridge D 2008).
Aboriginal and Torres Strait Islander young people
- ‘Injury has been recognised as a significant health issue for Aboriginal and Torres Strait Islander people of all ages with much higher rates of injury for specific causes than other Australians’ (Clapham et al 2016: 3).
- ‘Despite being only 5.5 % of the total child population in Australia, Indigenous children aged 0-17 represented almost 18% of injury deaths between 2007 and 2011 from both intentional and unintentional causes’ (Clapham et al 2019: 11).
- Injury and poisoning accounted for the highest proportion of hospitalisations for Aboriginal and Torres Strait Islander (ATSI) young people aged 10 to 24, with 25% of 15 to 19 year old ATSI young people hospitalised due to injury or poisoning (AIHW 2018).
- Hospitalisations for injury and poisoning were most common for Indigenous people aged between 20 and 24, with mortality rates in this age group also being the highest (AIHW 2018).
- ‘Indigenous children are hospitalised for injury at a rate almost 2 times higher than other Australians’ (Clapham et al 2019: 11).
- Another concern is that the rate of hospitalisations for Indigenous young people aged between 10 and 24 has increased from a rate of 120 per 1,000 hospitalisations in 2004-2005 to 166 per 1,000 in 2015-2016 (AIHW 2018).
- Rates of transport injury among Aboriginal and Torres Strait Islanders are 2 to 3 times higher than injury rates for non-Aboriginal and Torres Strait Islanders. A major contributing factor is low rates of licensed drivers due to the obstacles faced trying to get a license, such as financial barriers, access to suitable identifications, literacy and access to services (Cullen et al 2018).
- “Supporting Aboriginal and Torres Strait Islander people to safely and legally access affordable transport will reduce overcrowding and unsafe driving practices that stem from transport disadvantage and contribute to over-representation of Aboriginal and Torres Strait Islander people in road injury and incarceration” (Cullen et al, 2019 p. 5).
WHERE ARE YOUNG PEOPLE GETTING INJURED?
- 1 in 5 work injuries in Australia are incurred by young people under the age of 25 years (SafeWork Australia 2013).
- It is estimated the cost of work related injuries and illness to young workers in Australia is $12 billion per year (SafeWork Australia 2013).
- Two-thirds of young worker traumatic injury fatalities involved a vehicle (SafeWork Australia 2013).
- On average, every 4 minutes and 24 seconds a young person is injured in an Australian workplace (SafeWork Australia 2013).
- Research from NSW indicates that 15 to 25 year olds have a 75 per cent greater chance of being injured at work (SafeWork NSW 2017).
- In NSW alone, 15 workers in the 15 to 25 year age group are injured every day (SafeWork NSW 2017).
- During the period July 2013 to June 2014, young people aged between 15 and 19 years experienced an increase in the rate of work-related injuries or illnesses compared with 2009-10 (50 per 1000 persons in 2013-14 compared to 47 per 1000 persons in 2009-10). All other age groups experienced a decreased rate of work-related injury or illness (ABS 2014).
- Both globally and within Australia, young drivers are significantly over-represented among those killed or injured in road traffic accidents, as young drivers are more likely to engage in risky driving behaviours (AIHW 2011).
- Despite a reduction in fatalities, young drivers remain the most over-represented group of drivers involved in crashes on our roads. The highest period for risk is shortly after licensure, and continues up to age 24 (BITRE 2013).
- In Australia, the most common external cause of injury leading to hospitalisation was transport accidents, accounting for 21% of injury hospital separations among young people (AIHW 2011).
- More than 1,600 young drivers aged from 15 to 24 years have died on Australian roads in the past five years (TfNSW Centre for Road Safety 2015).
- Young adults have a greater proportion of single vehicle crashes, further reflecting their inexperience on the roads contributing to increased crash risk (BITRE 2013).
- Finding a car with the highest safety rating is important – young drivers are more likely to be in older cars which are not as safe (ANCAP 2017). Nearly 80 per cent of young drivers under 20 who died and 71 per cent of those who seriously injured in car crashes on the state’s roads in the past five years were driving cars older than 10 years (SMH 2017).
- In Australia serious injury rates for motorcyclists were the highest in the 15 -25 year old age group (Austroads 2014).
- In the five years between 2013 and 2017, riders under the age of 26 were 8% of the registered motorcycle owners however they made up just over 26% of the motorcycle rider casualties in NSW (TfNSW, Centre for Road Safety 2019).
- Motorcycle crashes involving speed, alcohol and fatigue are a concern, particularly for young and novice riders. For example, when compared to older riders, fatal crashes involving young and novice riders are:
– 5 times more likely to involve speed as a factor
– 4 times more likely to involve alcohol as a factor
– 3 times more likely to involve fatigue as a factor (TfNSW 2012).
- Alcohol is the most commonly used licit or illicit substance among young people. Consumption of alcohol in adolescence increases the risk of injury, violent behaviour, sexual risk taking, poor mental health and social problems (AIHW 2011).
- Alcohol is a key risk factor for injury among young people, with one in five drinkers aged 16-17 years reporting alcohol-related injuries (Livingston 2014).
- Alcohol accounts for 13 per cent of all deaths among 14–17-year-old Australians – it has been estimated that one Australian teenager dies and more than 60 are hospitalised each week from alcohol-related causes (NHMRC 2009).
- Whether or not a young person will start drinking and how they drink is heavily influenced by parental approval and modelling of alcohol consumption, as well as the drinking behaviour of a young person’s peers (Livingstone 2014).
- A range of personality traits can be linked to when a young person starts to drink alcohol, including impulsivity (Livingstone 2014).
- Studies have shown significant and detrimental effects in brain structure when heavy drinking is engaged in during the period of adolescence, where the brain is going through a number of significant changes (NHMRC 2009: Cservenka & Brumback 2017).
- It is positive to see that more young Australians are drinking less. Fewer 12–17 year olds were drinking alcohol and the proportion abstaining from alcohol significantly increased from 2013 to 2016 (from 72% to 82%). A significantly lower proportion of 18–24 year olds consumed 5 or more standard drinks on a monthly basis (from 47% in 2013 to 42% in 2016) (AIHW 2017).
- Those young Australians who do choose to drink do so at harmful levels on a single occasion than the rest of the adult population and males were more likely to drink at harmful levels than females (AIHW 2014).
- Nearly half (47%) of people (aged 12 or older) had their first glass of alcohol supplied by a friend and almost one-quarter (24%) were supplied their first glass by their parent (AIHW 2014).
- There is strong evidence that factors such as advertising exposure, pricing of alcohol products, the density of alcohol outlets and the legal purchasing age all impact adolescent drinking (Livingstone 2014).
Sport and recreation
- In Australia, the rate of sports injury hospitalisations was highest in the 18-24 year age group (AIHW: Kreisfeld et al. 2014).
- Sports and athletic areas were the most common place of [injury] occurrence for children aged 11-16 years (Mitchell et al 2017)
- Rates of sports injury in males is three times that of females (Finch et al 2011).
- The top 10 causes of sports injury hospitalisations, by type of sport:
Australian Rules Football
(Australian Institute of Health & Welfare: Kreisfeld et al 2014)
- In Australia nearly 75% of all bicycle-related emergency department presentations were children under 15 years (CARRS-Q 2011).
- Bike riders not wearing a helmet were almost four times as likely to sustain a severe head injury (TfNSW 2014).
INVESTING IN PREVENTION SAVES LIVES – AND MONEY
- A US study into a range of injury prevention programs worldwide estimates:
- For every USD$1 spent on Life Skills Training, USD$24.60 is saved
- For every USD$1 spent on general risk and protective programs, USD$18.90 is saved
- For every USD$1 spent on bicycle helmet laws (ages 3-14), USD $45 is saved
- For every USD$1 spent on Federal Road Safety Programs, USD$35.20 is saved
- For every USD$1 spent on Zero Alcohol Tolerance, Drivers under 21, USD$25 is saved
(Children’s Safety Network 2014)
- A WHO Europe report examined a range of studies worldwide, including an Australian study on alcohol impaired driving claimed that a saving of AUD$8,324,532 was made per month as a result of the intervention (WHO 2014).
- It is well recognised that the costs of reducing trauma from road crashes are borne in the health, social and productivity sectors of the economy. Some of the benefits of a judicious application of safety initiatives demonstrated to the inquiry show a return across portfolios of up to 20:1 (Australian Department of Infrastructure, Regional Development and Cities 2018).