What do we want to know?

In industrialised countries such as England and Wales, unintended injury (which ranges from sprains in sport to hospitalisation and death due to drugs or transport crashes) is the leading cause of death in children aged 0 to 14 years, and a major cause of death in young adults aged 15 to 24. It is also a major cause of ill health and disability in these age groups. There is a large body of research on young people and their perceived propensity to take risks. Common sense suggests that an increased willingness to place oneself at risk will result an increased likelihood of physical injury. However, given that pathways to injury are complex and not always well understood, the UK Department of Health commissioned a large systematic review to examine this multifaceted issue.

Who wants to know?

The key messages of this review may help particularly:

• policy-makers by highlighting where current policy relevant to reducing accidental injury among young people is supported by research evidence and where there are contradictions or gaps;
• health authorities and other services to assess the evidence-base for delivering injury prevention interventions to young people;
• researchers by highlighting areas where the evidence base is thin; also, in showing how research can be used to inform policy and practice, this review underlines the importance of detailed contextual information about study participants.

What did we find?

We found a very wide-ranging literature relevant to the subject, covering topics as diverse as drugs, alcohol, transport and sport. The review contributes a new perspective to the evidence base on risk-taking and injury by assessing explicitly the extent to which risk-taking contributes to accidental injury, and by locating this within the social circumstances in which young people find themselves. As well as examining the evidence for the above, it also contextualises its findings within current Government policy in a range of areas.

It concludes that, while there is a large literature on a ‘culture of risk-taking’ among young people, the evidence to support the view that this translates into significant numbers of injuries is limited.

What are the implications?

This review challenges the idea that ‘risk-taking’ is a helpful umbrella term to describe the motivations underlying a range of activities. While young people undoubtedly undertake actions that result in injury, this review suggests that a move away from individual behavioural explanations towards a focus on structures and material resources is likely to be a more productive approach to understanding overall patterns of accidental injury.

How did we get these results?

Our overarching review question, which was answered in different ways by the different types of evidence in the review, was:

What are the relationships between accidental injury, risk-taking behaviour and the social circumstances in which young people live?

We sought four main sources of evidence to answer this question:

• ‘correlational’ studies and
• UK national statistics which tell us injury rates according to different
  causes;
• studies which tell us about young people’s views and experiences in the UK;
  and
• systematic reviews of effectiveness to tell us ‘what works’ in preventing
  accidental injury internationally.

The inclusion of these different types of research is an important feature of this review. Its conclusions are drawn from international evaluations of injury prevention interventions, from the findings of ‘qualitative’ research examining the views and experiences of young people themselves conducted in the UK, and from gathering together what we know about the number and types of injuries suffered by young people.

We searched fifteen electronic databases, searched ten key journals by hand, scanned reference lists, contacted key informants and organisations, and searched websites for research to include in the review. After examining the research in detail and assessing it for relevance and quality, the review’s conclusions are based on 84 studies.

This report should be cited as: Thomas J, Kavanagh J, Tucker H, Burchett H, Tripney J, Oakley A (2007) Accidental injury, risk-taking behaviour and the social circumstances in which young people live: a systematic review. London: EPPI Centre, Social Science Research Unit, Institute of Education, University of London.