The role of public health in injury prevention

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1st European Conference on Injury Prevention and Safety Promotion

Vienna, Austria, 25-27 July 2006

The role of public health in injury prevention

Roberto Bertollini MD MPHDirector

Special Programme on Health and EnvironmentWHO Regional Office for Europe

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For every fatal injury, an estimated 30 people are hospitalized

and 300 require outpatient treatment in hospital emergency departments

1. Burden and costs

Injuries are the third leading cause of death in Europe, killing 800 000 people every year

1 death

30 hospital admissions

300 emergency department visits

?? self treated or general practice visits

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1. Burden and costs The burden of injuries

disproportionately affects younger people

Source: WHO, Global burden of disease 2002 rev.3

0

5

10

15

20

25

30

35

0-4 5-14 15-29 30-44 45-59 60-69 70-79 80+Age group

Dis

abil

ity

Ad

just

ed L

ife

Yea

rs (

DA

LY

s) l

ost

(%

)They not only experience premature deaths, but also live longer with disability

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1. Burden and costs Nowhere in the world is the difference between poorer and

wealthier countries in mortality from injury as high as in Europe

People in low- and middle-income countries (LMIC) are at 4 times more likely to die from injuries than people in high-income countries (HIC).

The achievements of the HIC, which are among the safest in the world, indicates that closing this gap IS possible.

Standardized mortality rate from all injuries in the WHO European Region for both sexes, 2002

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1. Burden and costs The cost of injuries to society is enormous

Societal costs have only begun to be mapped out:

• for RTIs, these have been estimated at 2% of national GDP

• for violence, only a few studies are available. In the United Kingdom, societal costs of domestic violence were estimated at nearly € 33 billion per year (1.9% UK GDP)

The health care cost of injuries is estimated at € 189 billion(Range € 81-296 billion)

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2. Opportunities for prevention Huge savings of lives could be achieved if all countries

in the Region equalled the performance of the safest

Injury by typeDeaths

observed per year (average)

Potential lives saved

Road traffic injuries 100,710 ca. 55,000 (54%)

Poisonings 101,519 ca. 95,000 (94%)

Falls 72,104 ca. 36,000 (51%)

Drowning 34,026 ca. 30,000 (90%)

Fires 21,742 ca. 19,000 (87%)

Self-inflicted injuries 145,493 ca. 88,000 (60%)

Interpersonal violence

61,717 ca. 55,000 (89%)

All injuries 746,512 ca. 508,000 (68%)

Potential life saving in Europe could reach 500 000 lives

Baseline period 2000-2002 or three most recent years. Population 849,496,543

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2. Opportunities for prevention

Many cost-effective measures exist

Sources:

Working to prevent and control injury in the United States- Fact Book for the year 2000. Atlanta, GA National Center for Injury Prevention and Control, 2000.

Caldwell RA. The costs of child abuse vs. child abuse prevention: Michigan’s experience. East Lasing, MI, Michigan Children’s Trust Fund, 1992.

Chapedelaine A, Maurice P. Firearms injury prevention and gun control in Canada. Canadian Medical Association Journal, 1996, 155: 1285-1289.

saves €19

saves €32€1 spent on child safety seats

saves €69€1 spent on smoke alarms

saves €10€1 spent on prevention counselling by paediatricians

€1 spent on home visitation and parent education against child abuse

Selected estimates of savings from investing in prevention

€1 spent on universal licensing of handguns saves €79

saves €3€1 spent on road safety improvements

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3. The way forward

Redefining the role of public health for injury prevention

Providing services for victims is only one of the roles that the health sector can play.

Policy

Public Health

Services for victims

Advocacy Injury surveillance, evaluation

Prevention & control

Research

Other roles offer further opportunities to reduce the burden of injuries.

Engaging other sectors

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3. The way forward Resolution on prevention of injuries in the

European Region (EUR/RC55/R9)

Member States and the WHO have taken commitments to:

• Develop national plans for injury prevention• Improve national surveillance• Strengthen national capacity to respond to the

burden of injury and provide services for victim• Advocate effective injury prevention activities• Promote good practice and the exchange of

knowledge across the Region• Prioritize research in primary prevention and trauma

care• Strengthen partnerships across sectors and

stakeholders• Report back on progress achieved in 2008

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Thank you for your attention!

http://www.euro.who.int/violenceinjury

The role of public health in injury prevention

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