Discuss as: Teen fistfights down in many nations, but not US By Vitals Wednesday Dec 5, 2012 1:00 PM Email By Reuters staff Fistfights among children have become less common over the last decade in 19 out of 30 countries surveyed in a Canadian study - but fighting in the United States and Canada has remained steady, while it has risen in countries such as Greece. "It was not something that we anticipated," said William Pickett, lead author of the study, which appeared in the journal Pediatrics. "If anything, given what you hear in the news, I would have anticipated the reverse." Fighting among children is an important public health problem, added Pickett, a professor at Queen's University in Kingston, Canada. Not only does it increase their chances of getting hurt, but it's also tied up in other dangerous behaviors, such as drinking and using drugs. To gauge how big the problem is internationally, Pickett and his colleagues surveyed nearly half a million school children in 30 countries, most of them in Europe. The children were between 11 and 15 years old. In 2002, 154,000 children responded to the questionnaire, which asked how often they fought. Another 166,000 responded in 2006, and 174,000 responded in 2010. Taken together, nearly 14 percent of the children reported that they got into a fight at least three times in the previous 12 months in 2002. That number dropped closer to 13 percent in 2006, and in 2010 to 11.6 percent. "We saw this as very positive news," Pickett told Reuters Health. "As society has evolved, there's probably less tolerance of fighting in school systems and probably (more prevention) efforts across these countries." Fighting in the United States ranged from nearly 12 percent of children to close to 10 percent, depending on the year, but there was no obvious decline. "It's reassuring that the rates aren't going up," said Rashmi Shetgiri, a pediatrician and violence prevention researcher at the University of Texas Southwestern Medical Center, who was not involved in the study. "(But) it makes me wonder, have we sort of reached a plateau in terms of the interventions that we're using, and do we need to develop some different types of interventions or use them in a different way to really make those rates start going down again," she told Reuters Health. Shetgiri said programs to curb bullying and improve social skills have been successful in reducing fighting, but perhaps tailoring them to specific racial and ethnic groups could have an even bigger impact. Pickett pointed out that the United States, Canada and several other countries did show modest improvements in fighting rates, but the differences were so small that they could have been due to chance. Greater numbers of children reported fighting in Greece, Latvia and the Ukraine reported fighting during each subsequent survey, and the authored pointed out that these countries experienced considerable economic instability during the study time period. In addition, they found that children from low income countries were more likely to fight than kids from wealthier nations. "If economic instability is the problem, we should monitor this because of what is going on in the world these days," Pickett said.