Bullying in children: impact on child health
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Key messages:
-Bullying in childhood is a global public health problem that impacts child, adolescent, and adult health.

-Bullying exists in its traditional, sexual, and cyber forms, all of which impact the physical, mental and social health of victims, bullies, and bully victims.

-Children perceived as ‘different’ in any way are at greater risk of victimization.

-Bullying is extremely prevalent: one in three children globally has been victimized in the preceding month.

-Existing bullying prevention interventions are rarely evidence-based and alternative approaches are urgently needed.

Bullying in childhood is a major public health problem that increases the risk of poor health, social and educational outcomes in childhood and adolescence. These consequences are felt by all those involved in bullying (bullies, victims, and bully-victims) and are now recognized to propagate deep into adulthood. Cyberbullying is a relatively new type of bullying in addition to the traditional forms of direct physical, direct verbal, and indirect bullying. Children who are perceived as being ‘different’ in any way are at greater risk of victimization, with physical appearance being the most frequent trigger of childhood bullying. Globally, one in three children has been bullied in the past 30 days, although there is substantial regional variation in the prevalence and type of bullying experience.

The consequences of childhood bullying can be categorized into three broad categories: educational consequences during childhood, health consequences during childhood, and all consequences during adulthood. Many dose-response relationships exist between the frequency and intensity of bullying experienced and the severity of negative health consequences reported. The majority of victims of cyberbullying are also victims of traditional bullying, meaning cyberbullying creates very few additional victims. Overall, adverse mental health outcomes due to bullying in childhood most severely impact bully victims. Bullying prevention is vital for the achievement of the Sustainable Development Goals, with whole-school cooperative learning interventions having the strongest evidence base for successful outcomes. Clear management and referral pathways for health professionals dealing with childhood bullying are lacking in both primary and secondary care, although specialist services are available locally and online.