Assessment of non-fatal injuries among university students in Hainan: a machine learning approach to exploring key factors.

Background: Injuries constitute a significant global public health concern, particularly among individuals aged 0-34. These injuries are affected by various social, psychological, and physiological factors and are no longer viewed merely as accidental occurrences. Existing research has identified multiple risk factors for injuries; however, they often focus on the cases of children or the older adult, neglecting the university students. Machine learning (ML) can provide advanced analytics and is better suited to complex, nonlinear data compared to traditional methods. That said, ML has been underutilized in injury research despite its great potential. To fill this gap, this study applies ML to analyze injury data among university students in Hainan Province. The purpose is to provide insights into developing effective prevention strategies. To explore the relationship between scores on the self-rating anxiety scale and self-rating depression scale and the risk of non-fatal injuries within 1 year, we categorized these scores into two groups using restricted cubic splines. Methods: Chi-square tests and LASSO regression analysis were employed to filter factors potentially associated with non-fatal injuries. The Synthetic Minority Over-Sampling Technique (SMOTE) was applied to balance the dataset. Subsequent analyses were conducted using random forest, logistic regression, decision tree, and XGBoost models. Each model underwent 10-fold cross-validation to mitigate overfitting, with hyperparameters being optimized to improve performance. SHAP was utilized to identify the primary factors influencing non-fatal injuries. Results: The Random Forest model has proved effective in this study. It identified three primary risk factors for predicting non-fatal injuries: being male, favorable household financial situation, and stable relationship. Protective factors include reduced internet time and being an only child in the family. Conclusion: The study highlighted five key factors influencing non-fatal injuries: sex, household financial situation, relationship stability, internet time, and sibling status. In identifying these factors, the Random Forest, Logistic Regression, Decision Tree, and XGBoost models demonstrated varying effectiveness, with the Random Forest model exhibiting superior performance.