Open Access Open Badges Research article

Intentional injury reported by young people in the Federated States of Micronesia, Kingdom of Tonga and Vanuatu

Ben J Smith1*, Philayrath Phongsavan2, Dale Bampton3, Genevieve Peacocke4, Mercedes Gilmete5, Drew Havea6, Tien Chey2 and Adrian E Bauman2

Author Affiliations

1 Department of Health Science, Monash University, PO Box 527 Frankston, Victoria, 3199, Australia

2 School of Public Health, Lev 2, Medical Foundation Blg K25, University of Sydney, New South Wales, 2006, Australia

3 Maurice Blackburn Cashman Pty Ltd, Level 20, 201 Elizabeth Street, Sydney, NSW, 2000, Australia

4 Pfizer Australia, PO Box 57, West Ryde, New South Wales, 2114, Australia

5 PO Box 723, Kolonia, Pohnpei, 96941, Federated States of Micronesia

6 Training Group of the Pacific, PO Box 132, Nuku'alofa, Tonga

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BMC Public Health 2008, 8:145  doi:10.1186/1471-2458-8-145

Published: 30 April 2008



Intentional injury presents a threat to the physical and psychological well being of young people, especially in developing countries, which carry the greatest part of the global injury burden. While the importance of this problem is recognized, there are limited population data in low and middle income countries that can guide public health action. The present study investigates the prevalence and distribution of intentional injury among young people in three Pacific Island societies, and examines behavioural and psychosocial factors related to risk of intentional injury.


Population surveys were conducted with students aged 11–17 years in Pohnpei State in the Federated States of Micronesia (n = 1495), the Kingdom of Tonga (n = 2808) and Vanuatu (n = 4474). Surveys measured self-reported injury and intentional injury, sources of intentional injury, and the range of behavioural, psychological, educational and social variables that may be related to injury risk.


Among boys and girls aged 14–17 years the respective period prevalence of intentional injury was 62% and 56% in Pohnpei, 58% and 41% in Tonga, and 33% and 24% in Vanuatu. The prevalence of intentional injury declined with age in Tonga and Vanuatu, but there was little evidence of an age-trend in Pohnpei. Across the three societies, the major sources of intentional injury among boys were 'other persons' followed by boyfriends/girlfriends and fathers. Mothers, boyfriends/girlfriends and other persons were primary sources of injury among girls. An intentional injury was reported more often by those who had been bullied (OR 1.40–1.66, P < 0.05), by regular smokers in Tonga and Vanuatu (OR 1.52–2.21, P < 0.05), and illicit drug users in Pohnpei and Vanuatu (OR 1.87–1.92, P < 0.05).


Intentional injury was reported extensively in these three populations. Interventions directed towards the school environment and which take into account the role of bullying and drug use need to be considered.