Injuries From Car Crashes, Self Harm, And Other Activities Down By A Third Worldwide; Still A High 'Burden' For Some Nations

Man in head bandage
Injuries worldwide have declined since 1990, and so has their impact on our health, a new study finds. Soumyadeep Paul, CC BY 2.0

In news that’s sure to mollify worrisome grandparents everywhere, it seems the average person across the globe is not only significantly less injury-prone but also less likely to die or become chronically disabled as a result of injury than they were a quarter-century ago.

Researchers in the journal Injury Prevention published a study Thursday showing that the global health burden brought on by injuries has substantially declined from 1990 to 2013. Though nearly a billion people (973 million) sustained some sort of injury that needed medical attention in 2013, these injuries’ overall effect on premature death and disability plummeted over 30 percent compared to 1990, the authors found. Similarly, the rate of injuries, whether caused by a car accident, fire, or self-harm, took a sharp plunge downwards as well.

“The decline in rates for almost all injuries is so prominent that it warrants a general statement that the world is becoming a safer place to live in,” they wrote. “However, the patterns vary widely by cause, age, sex, region and time and there are still large improvements that need to be made.”

A Life Measured

To come to their conclusions, the researchers turned to data collected by the World Bank during their Global Burden of Diseases and Injuries, and Risk Factors Study, or GBD for short. Intended to be “the largest and most comprehensive effort to date to measure epidemiological levels and trends worldwide,” the GBD study was first run in 1990, then in 2010, and now annually since 2013.

With that extensive data on injuries from over a hundred countries, the researchers were then able to compare its toll on human health between 1990 and 2013, using a measure known as the disability-adjusted life year (DALY). The DALY combines two other commonly used measures, which respectively calculate premature mortality— years of life lost (YLL) — and the amount of healthy years lost to disability — years of life lived with a disability (YLD).

When taken as a whole, they saw a dramatic decline of 30 percent in the global DALY injury rate, after standardizing for age. The largest declines, however, were seen in higher income countries, with the least improved regions being Oceania (Australia and surrounding island nations), and West, central and southern sub-Saharan Africa.

Different types of injury saw different declines as well, with road injuries (responsible for 29 percent of those seen in 2013) dropping 15 percent in its global DALY rate, while slips and falls, which have become more prevalent as people have lived longer on average, still fell 20 percent. Some of the largest decreases in health burden were seen for drownings, poisonings, and injuries caused by fire or heat. “The rate of decline was significant for 22 of our 26 cause-of-injury categories, including all the major ones,” the researchers wrote.

While the incidence rate of injuries did collectively decline, that decrease wasn’t solely responsible for their lowered toll on human health. The fact that less people have died or become chronically disabled as a result of injury was likely “brought about by injury prevention measures reducing the severity of the injury sustained (eg, seat belts and helmets) or by improved access to better quality care after an injury (eg, trauma systems),” the authors explained.

Interestingly, the global economic fallout that occurred around 2008 didn’t appear to dampen the overall trend of reduction in injuries or DALYs caused by self-harm and suicides — they do however remain the second leading cause of death among injuries. On the other side, while injuries caused by war or violence have declined as well, they will remain a substantial cause of long-lasting disability for those entering their later years.

“The findings from the GBD are a valuable resource for countries to prioritise major contributors of injury deaths, incidence and/or DALYs and monitor progress over time,” the authors concluded. “Changes over time can facilitate in raising hypotheses regarding the underlying causes.”

Source: Haagsma J, Graetz N, Bolliger I, et al.The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013. Injury Prevention. 2015.

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