Effect of injuries worldwide has fallen by almost a third since 1990
BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h6548 (Published 04 December 2015) Cite this as: BMJ 2015;351:h6548The global toll taken by injuries on daily life has fallen by almost a third in 23 years, researchers have found, concluding that “the world is becoming a safer place to live in.”
The Global Burden of Diseases, Injuries, and Risk Factors (GBD) studies, first commissioned by the World Bank in the early 1990s, have shown that injury is a substantial cause of ill health and death in the developing and developed world.
For the latest study, published in the journal Injury Prevention, a global collaboration of researchers mined the 2013 GBD study and compared the types and impacts of injuries around the world with findings from 1990.1
The team used data on the number of injuries, deaths from injuries, and disability adjusted life years (DALYs—the sum of years of life lost to death and years of life lived with a disability). They calculated that, in 2013, almost a billion people (973 million) sustained injuries that required medical attention or treatment, accounting for 10% of the global toll of disease.
Injuries remain an important cause of ill health and death, the calculations showed, but from 1990 to 2013 the global DALY, standardised for age, fell by almost a third (31%).
Major causes of injury included car crashes, which made up 29% of the total, and self harm, which included suicide (17.6%), falls (11.6%), and violence (8.5%). Among people whose injuries required some treatment just under 6% required admission to hospital. The largest category of injury requiring admission was fracture (38.5%).
In almost all regions of the world injury rates were higher in men than in women, until age 80. Almost five million people died of their injuries.
The drop in DALY rates was significant in 22 of the 26 causes of injury, including drowning (–52%), injuries from fire and heat (–47%), poisoning (–44%), falls (–21%), and road injury (–16%). But the study found some variations according to age, gender, geography, and time. DALYs among under 15s were lowest in western Europe and highest in central sub-Saharan Africa.
Road traffic injuries were most common among 15 to 49 year olds. Among road injuries in western Europe, Australasia, and Asia Pacific, DALY rates fell by more than 50% from 1990 to 2013, but they rose by 10-20% in high income Asia Pacific and western sub-Saharan Africa and by 30-40% in southern Africa.
“These decreases in DALY rates for almost all cause of injury categories warrant a general statement that the world is becoming a safer place to live in, although the injury burden remains high in some parts of the world,” concluded the researchers.
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Cite this as: BMJ 2015;351:h6548