Measuring adolescent behaviors related to intentional injuries.

B Y ANY TRADITIONAL MEASURE of public health importance, intentional injuries (injuries resulting from interpersonal violence including homicide or self-directed violence including suicide) are among the most important public health problems facing our nation. In 1985, the direct and indirect costs of deaths and hospitalizations resulting from intentional injuries were estimated to be $26 billion (1). Victimization from intentional injuries is often a powerful indicatorofriskforfuturevictimization. Violence among family members or intimates is known to occur repeatedly (2,3). Exposure to interpersonal violence early in life can increase risk of violence later in life. Child abuse victims are at increased risk of behaving violently toward others and committing violent crimes (4,5). Adults who witness violence in their family as children are at increased risk for perpetration ofphysical abuse against, and for victimization from physical abuse by, their spouses or intimates (6,7). Attempted suicide is one of the strongest indicators of risk for death from a future suicide attempt (8-10). Like many other public health problems, mortality and morbidity from interpersonal and self-directed violence can be reduced by decreasing the prevalence of related risk behaviors. Current information about the incidence and prevalence of the most important risk behaviors is needed to identify groups at high risk of intentional injuries, to develop interventions to decrease the incidence of related risk behaviors, and to evaluate the effectiveness of those interventions (11). This paper describes the development of questions related to intentional injuries for the Youth Risk Behavior Surveillance System (YRBSS) questionnaire. The YRBSS Panel participants (see Appendix I, page 56) firstidentifiedtheleadingcausesofmortalityandmorbidity associated with intentional injuries. Guided by national health objectives for the year 2000 (1 1), we developed questions that would elicit information on priority behaviors related to intentional injuries among adolescents. MortlIty from Intentional Injuries

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