Country level economic disparities in child injury mortality

Khan, Uzma Rahim; Sengoelge, Mathilde; Zia, Nukhba; Razzak, Junaid Abdul; Hasselberg, Marie; Laflamme, Lucie

doi:10.1136/archdischild-2013-305847

Cited by 18 publications

(17 citation statements)

References 24 publications

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“…Deaths are then rescaled for each cause so that the sum equals the number of deaths from all causes to ensure internal consistency. YLLs were calculated by multiplying deaths by the residual life expectancy at the age of death based on the GBD 2017 standard model life table 12…”

Section: Methodsmentioning

confidence: 99%

“…Up till now, few studies have been performed that studied the relationship between sociodemographic changes and overall injury rates. There have been reports on the associations of gross domestic product and unemployment with suicides, homicides, road injury and unintentional injuries 5–12. However, these studies focused on one specific cause of injury and on one type of injury outcome, mostly mortality.…”

Section: Introductionmentioning

confidence: 99%

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Burden of injury along the development spectrum: associations between the Socio-demographic Index and disability-adjusted life year estimates from the Global Burden of Disease Study 2017

et al. 2020

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BackgroundThe epidemiological transition of non-communicable diseases replacing infectious diseases as the main contributors to disease burden has been well documented in global health literature. Less focus, however, has been given to the relationship between sociodemographic changes and injury. The aim of this study was to examine the association between disability-adjusted life years (DALYs) from injury for 195 countries and territories at different levels along the development spectrum between 1990 and 2017 based on the Global Burden of Disease (GBD) 2017 estimates.MethodsInjury mortality was estimated using the GBD mortality database, corrections for garbage coding and CODEm—the cause of death ensemble modelling tool. Morbidity estimation was based on surveys and inpatient and outpatient data sets for 30 cause-of-injury with 47 nature-of-injury categories each. The Socio-demographic Index (SDI) is a composite indicator that includes lagged income per capita, average educational attainment over age 15 years and total fertility rate.ResultsFor many causes of injury, age-standardised DALY rates declined with increasing SDI, although road injury, interpersonal violence and self-harm did not follow this pattern. Particularly for self-harm opposing patterns were observed in regions with similar SDI levels. For road injuries, this effect was less pronounced.ConclusionsThe overall global pattern is that of declining injury burden with increasing SDI. However, not all injuries follow this pattern, which suggests multiple underlying mechanisms influencing injury DALYs. There is a need for a detailed understanding of these patterns to help to inform national and global efforts to address injury-related health outcomes across the development spectrum.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Burden of injury along the development spectrum: associations between the Socio-demographic Index and disability-adjusted life year estimates from the Global Burden of Disease Study 2017

et al. 2020

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“…This relationship has also been established in the injury field for children under five (Khan et al, 2015) and in the 1–19 age group globally (Peden et al, 2008). For child burns, 2004 data at the global level showed that mortality was nearly 11 times higher in low-income countries than in high-income countries (Peden et al, 2008).…”

Section: Introductionmentioning

confidence: 78%

The global burden of child burn injuries in light of country level economic development and income inequality

Sengoelge

El‐Khatib

Laflamme

2017

Preventive Medicine Reports

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Child burn mortality differs widely between regions and is closely related to material deprivation, but reports on their global distribution are few. Investigating their country level distribution in light of economic level and income inequality will help assess the potential for macro-level improvements. We extracted data for child burn mortality from the Global Burden of Disease study 2013 and combined data into 1–14 years to calculate rates at country, region and income levels. We also compiled potential lives saved. Then we examined the relationship between country level gross domestic product per capita from the World Bank and income inequality (Gini Index) from the Standardized World Income Inequality Database and child burn mortality using Spearman coefficient correlations. Worldwide, the burden of child burn deaths is 2.5 per 100,000 across 103 countries with the largest burden in Sub-Saharan Africa (4.5 per 100,000). Thirty-four thousand lives could be saved yearly if all countries in the world had the same rates as the best performing group of high-income countries; the majority in low-income countries. There was a negative graded association between economic level and child burns for all countries aggregated and at regional level, but no consistent pattern existed for income inequality at regional level. The burden of child burn mortality varies by region and income level with prevention efforts needed most urgently in middle-income countries and Sub-Saharan Africa. Investment in safe living conditions and access to medical care are paramount to achieving further reductions in the global burden of preventable child burn deaths.

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“…Increased risk of severe injuries related to poverty (for those with worsening income opportunities); reduction in parental supervision; increase in affluence leads to exposure to risk from unsafe operations of newly acquired product/devices 4 Several studies have shown that low socioeconomic status is strongly associated with child unintentional injuries, 4,20,22 and that most child unintentional injuries occur within in home settings. 4 Hence, improving living wages for families who participate in the manufacture of goods and services intended for globalized markets would impact living conditions and potentially reduce the risk of child unintentional injuries.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, there is a correlation between economic development and increase in proportionate mortality from child unintentional injuries. 20 This correlation is driven in part by the forces of globalization maintained by complex international laws that increase labor and free market access, which disproportionately shifts economic gains and risk factors of child unintentional injuries between the HIC and LMIC. Recognizing the growing inequalities in the benefits of globalization between HIC and LMIC is at the crux of understanding pathways for leveraging globalization to reduce deaths and morbidity from child unintentional injuries.…”

Section: Discussionmentioning

confidence: 99%