1. International Perspectives on Adolescent Violence

2. Co-investigators Mary D. Overpeck, DrPH Peter C. Scheidt, MD, MPH Acknowlegement : Patricia Moyer, NICHD Lois Fingerhut, NCHS/CDC

3. Data Sources Mortality – WHO Statistics – International Collaborative Effort on Injury Statistics

4. Nonfatal Data Source WHO study of Health Behavior in School Children 1997/98 Survey

5. Injury Mortality Rates by Intent Age 15-19 Source is latest data available from WHO Statistics Website Averaging about 10 years of data for each country

6. UnintentionalSuicideHomicide Undetermine d Other violence/war USA Injury Mortality rates for ages 15-19 years by intent

7. Deaths by Mechanism Mechanism describes how someone died e.g. firearms, cutting/piercing, suffocation

8. Mechanism of Homicides - Age 15 - 24

9. Mechanism of Suicides - Age 15 - 24

10. Non-fatal Behaviors WHO Study of Health Behavior in School-aged Children Nationally representative surveys of 11, 13 & 15 year old youth in 29 countries Self report, school based surveys

11.  Conducted academic year 1997-98  120,000 respondents  95% CI’s for percents shown are about 2.5% for each country METHODS

12. VARIABLES Fighting, bullying, weapon carrying Other health-related and risk behaviors School, family and peer factors

13. BULLYING DEFINITION

14. We say a student is BEING BULLIED when another student, or a group of students say or do nasty and unpleasant things to him or her. It is also BULLYING when a student is teased repeatedly in a way he or she doesn’t like. But it is NOT BULLYING when two students of about the same strength quarrel or fight.

15. How often have you been bullied in school this term? USA

16. How often have you taken part in bullying other students? USA

17. Do you feel safe at school?

18. During the past 12 months, how many times were you in a physical fight?

19. The last time you were in a physical fight, with whom did you fight?

20. 0%20%40%60%80%100% USA Republic of Ireland Portugal Israel Hungary Estonia Belgium-Flemish Percent not Carrying During the past 30 days, on how many days did you carry a weapon, such as a gun, knife or club, for self-defense?

21. COMPARISONS OF FIGHTING AND HOMICIDE 18.6 60.2USA 0.861.2 Sweden 0.6 55.6 Irish Rep 0.9Portugal 68.8 1.0 54.6Israel 11.4 Estonia 60.6 15-19 yrs Homicide Rates % Not Fighting Country

22. Summary Primary difference between fatality rates among U.S. and other countries is the homicide rates Behavioral data indicate that U.S. adolescents are no more violent than those in most other countries

23. Discussion Comparability of data for fatalities and nonfatal behavior Other studies of violence, bullying, fighting and weapon carrying Effective targeting of interventions for violence