The more complicated life gets, the more opportunities we have to injure ourselves — or others. Or so you might think. According to research published in the online journal Injury Prevention, the global toll of injuries in daily life has fallen by almost a third in the past quarter of a century.
Factors of fractures
The Global Burden of Diseases, Injuries and Risk Factors (GBD) study was first commissioned by the World Bank in the early 1990s. The Institute for Health Metrics and Evaluation describes the GBD as an attempt to quantify the complex impact of global health in order to make worldwide health systems more well-informed. The study has repeatedly shown how injury has emerged as a "substantial cause" of ill health and death in both the developing and developed world.
As part of a global collaboration, the researchers looked at the latest GBD figures for 2013 to examine the impact of 26 causes of injury and 47 types of injury, dating back to 1990, for 188 countries in 21 regions of the world. They factored in data on the number of injuries, deaths from injuries, and a measure known as "disability adjusted life years," or DALY. The DALY figure is calculated by adding together the number of years of life lost to death or those lived with a disability.
Putting it together
The researchers calculated that, in 2013, almost a billion people (973 million) sustained injuries that required medical attention and/or treatment — this accounted for 10 percent of the global toll. Among the major causes of injury were car crashes (which made up 29 percent of the total), self-harm and suicide (17.6 percent), falls (11.6 percent) and violence (8.5 percent). Among those whose injuries warranted some form of healthcare, just less than 6 percent required admission to hospital. The most common cause of those official admissions (38.5 percent) was fractures. In almost every region of the world the team looked at — perhaps not too surprisingly — injury rates were higher in men than in women, until the age of 80.
The figures speak for themselves. Globally, injuries remain an important cause of ill health and death — worldwide, almost 5 million people died of their injuries. However, between 1990 and 2013, when it was adjusted for age, the global DALY fell by 31 percent — that's almost a third. The researchers found this fall to have been significant for 22 of the 26 reported causes of injury, including all the major ones. But there were some variations, according to age, gender, geography and time.
A safer world
DALY figures among those under the age of 15 seemed to reflect general life expectancy being lowest in Western Europe and highest in central Sub-Saharan Africa. The rates for road traffic injuries were perhaps the most telling. Among 15 to 49 year olds — the peak age category for such injuries — there was an eightfold difference in rates between the high income Asia Pacific region and western Sub-Saharan Africa. Rates were 70 percent higher in North America than in Western Europe, Australasia and Asia Pacific.
This new approach to assessing the data should improve the figures still further, the researchers suggest, by improving the efficiency of health responders. "For many decades, injury epidemiologists have largely relied on mortality data," they say. "the DALY provides a more comprehensive measure of the relative magnitude of different health problems for health planning purposes." The researchers conclude: "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."