Global injury and violence
http://www.100md.com
《加拿大医疗协会学报》
Injury is the ninth most common cause of premature death worldwide and the third most common cause of years lived with disability.1 Many early deaths are related to traffic accidents: each year, crashes of road vehicles kill 1.2 million people (3242 deaths/day) and injure or disable 20–50 million more.2 The Global Burden of Disease Study,1 conducted in the early 1990s, predicted that traffic-related injuries will become the third largest contributor to global death and disability by the year 2020.2
Most traffic-related deaths take place in low-and middle-income countries, mostly among young men 15–44 years old, who are involved in 77% of all vehicular collisions. Pedestrians, cyclists, passengers on public transport and riders of motorized 2-wheeled vehicles are those most commonly harmed.2 Affected families are impoverished by health care costs and loss of income. Even countries are debilitated: costs to low-and middle-income countries exceed US$65 billion per year,2 which is more than the total amount received in these countries for development assistance.
Figure. Two posters from the World Health Organization's Global Campaign for Violence Prevention. The text on this poster reads, "More than 540 adolescents and young adults die every day as a result of interpersonal violence: more than 20 deaths each hour."
Figure. On this poster from WHO's Global Campaign for Violence Prevention, the text reads, "90% of deaths due to road crashes occur in developing countries, mostly among pedestrians, bicyclists and motorcyclists — those less likely to own a car. Road safety is no accident." www.who.int/violence_injury_prevention Photo by: WHO
In Child and Adolescent Injury Prevention: A Global Call to Action (http://whqlibdoc.who.int/publications/2005/9241593415_eng.pdf), the World Health Organization (WHO) reportedin 2005 that the most common causes of childhood injuries are road-related collisions, drownings, burns and falls — although child abuse and youth violence are also leading causes of death, especially deaths of older children. Almost a million children and adolescents are injured each year by road-vehicle crashes; again, these injuries occur mostly (95%) within low-and middle-income countries.
"Accidents" were formerly regarded as random events that were unavoidable. A better understanding of their nature has meant that injuries are now seen to be largely avoidable. As a result, injury prevention is now prominent on many public health agendas (Box 2).
Prevention efforts for traffic-related injuries centre on addressing individual and broader environmental factors that contribute to injuries. WHO recommends that countries develop a national strategy for improved transport safety that includes road engineering and transport planning agencies as well as health, education and law-enforcement bodies.2 It also calls for the specific allocation of financial and human resources and for the implementation of specific actions such as compulsory seat belts, child restraints and helmets; lowered speed limits; blood alcohol limits; and safe vehicle and road design (Box 3).
Current preventive approaches to violence received worldwide attention in 1996 when the World Health Assembly adopted a resolution declaring violence a leading problem in public health.3 This followed earlier calls to address the effect of violence against women and girls and world citizen safety (Box 4). As with injury, the management and understanding of violence is moving away from a "law-and-order" approach to a public health approach with emphasis on prevention and root-cause management.3 Primary prevention approaches include training for good parenting skills, improved urban infrastructure, social development programs for adolescents and children, and efforts to reduce the global drugs and arms trades.3
With raised awareness, better evidence as to what prevention strategies are effective, and community commitment to the problems of injury and violence, it is hoped that we can tackle the problem of largely preventable deaths.
REFERENCES
Murray CJ, Lopez AD, editors. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Cambridge (MA): Harvard University Press; 1996.
World Health Organization. World report on road traffic injury prevention. Geneva: WHO; 2004. Available: www.who.int/violence_injury_prevention/en(accessed 2006 Jan 24).
World Health Organization. World report on violence and health. Geneva: WHO; 2002. Available: www.who.int/violence_injury_prevention/en (accessed 2006 Jan 24).
Most traffic-related deaths take place in low-and middle-income countries, mostly among young men 15–44 years old, who are involved in 77% of all vehicular collisions. Pedestrians, cyclists, passengers on public transport and riders of motorized 2-wheeled vehicles are those most commonly harmed.2 Affected families are impoverished by health care costs and loss of income. Even countries are debilitated: costs to low-and middle-income countries exceed US$65 billion per year,2 which is more than the total amount received in these countries for development assistance.
Figure. Two posters from the World Health Organization's Global Campaign for Violence Prevention. The text on this poster reads, "More than 540 adolescents and young adults die every day as a result of interpersonal violence: more than 20 deaths each hour."
Figure. On this poster from WHO's Global Campaign for Violence Prevention, the text reads, "90% of deaths due to road crashes occur in developing countries, mostly among pedestrians, bicyclists and motorcyclists — those less likely to own a car. Road safety is no accident." www.who.int/violence_injury_prevention Photo by: WHO
In Child and Adolescent Injury Prevention: A Global Call to Action (http://whqlibdoc.who.int/publications/2005/9241593415_eng.pdf), the World Health Organization (WHO) reportedin 2005 that the most common causes of childhood injuries are road-related collisions, drownings, burns and falls — although child abuse and youth violence are also leading causes of death, especially deaths of older children. Almost a million children and adolescents are injured each year by road-vehicle crashes; again, these injuries occur mostly (95%) within low-and middle-income countries.
"Accidents" were formerly regarded as random events that were unavoidable. A better understanding of their nature has meant that injuries are now seen to be largely avoidable. As a result, injury prevention is now prominent on many public health agendas (Box 2).
Prevention efforts for traffic-related injuries centre on addressing individual and broader environmental factors that contribute to injuries. WHO recommends that countries develop a national strategy for improved transport safety that includes road engineering and transport planning agencies as well as health, education and law-enforcement bodies.2 It also calls for the specific allocation of financial and human resources and for the implementation of specific actions such as compulsory seat belts, child restraints and helmets; lowered speed limits; blood alcohol limits; and safe vehicle and road design (Box 3).
Current preventive approaches to violence received worldwide attention in 1996 when the World Health Assembly adopted a resolution declaring violence a leading problem in public health.3 This followed earlier calls to address the effect of violence against women and girls and world citizen safety (Box 4). As with injury, the management and understanding of violence is moving away from a "law-and-order" approach to a public health approach with emphasis on prevention and root-cause management.3 Primary prevention approaches include training for good parenting skills, improved urban infrastructure, social development programs for adolescents and children, and efforts to reduce the global drugs and arms trades.3
With raised awareness, better evidence as to what prevention strategies are effective, and community commitment to the problems of injury and violence, it is hoped that we can tackle the problem of largely preventable deaths.
REFERENCES
Murray CJ, Lopez AD, editors. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Cambridge (MA): Harvard University Press; 1996.
World Health Organization. World report on road traffic injury prevention. Geneva: WHO; 2004. Available: www.who.int/violence_injury_prevention/en(accessed 2006 Jan 24).
World Health Organization. World report on violence and health. Geneva: WHO; 2002. Available: www.who.int/violence_injury_prevention/en (accessed 2006 Jan 24).