Social Indicators with Serious Injury and School Bullying Victimization in Vulnerable Adolescents Aged 12-15: Data from the Global School-Based Student Survey

Objective: The prevalence rates of injury and bullying victimization in adolescents are continuing to rise; how-ever, little is known about the influence of social determinants, especially for vulnerable adolescents. We aimed to estimate the prevalence of serious injury and bullying victimization in vulnerable adolescents with mental health issues or poor social support and examine the associations between social indicators and these two outcomes.Method: We used the most recent datasets from the Global School-based Student Health Survey, and vulnerable adolescents aged 12-15 years from 54 countries were included. The pooled overall and regional estimates were obtained by random-effects models. Multivariable logistic regression was performed to estimate the adjusted association between five common social indicators and the two outcomes. Dose-response association was esti-mated by using a restricted cubic spline.Results: The prevalence rates of serious injury and bullying victimization were high in vulnerable adolescents, with apparent variation between regions and countries. The pooled prevalence of serious injury ranged from 45.10 % to 50.11 %, whereas the pooled prevalence of bullying victimization ranged from 35.54 % to 45.21 %. Social indicators of national wealth, health status, income and gender inequality were significantly associated with the prevalence of serious injury and bullying victimization in vulnerable adolescents. Conclusions: Serious injury and school bullying victimization are prevalent in vulnerable adolescents aged 12-15 years. Social indicators were prominent associated factors of serious injury and bullying victimization in vulnerable adolescents. The results emphasize the importance of social environment when developing inter-vention measures to address injury and bullying among disadvantaged teenagers.