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Mchunu GG, Sokhela DG, Pillay Y, Niranjan I, Nxumalo CT. Promoting health and safety in public transportation: A call to action for sub-Saharan Africa. Afr J Prim Health Care Fam Med 2025; 17:e1-e5. [PMID: 40336426 PMCID: PMC12067542 DOI: 10.4102/phcfm.v17i1.4570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 07/11/2024] [Accepted: 02/28/2025] [Indexed: 05/09/2025] Open
Abstract
Road Traffic Incidents (RTIs) are a major public health concern worldwide, particularly in low-income to middle-income regions such as sub-Saharan Africa. Data from sub-Saharan Africa suggests that the public transport industry accounts for the majority of fatal crashes that contribute to the high mortality and morbidity associated with RTIs. In this viewpoint, we advocate for integrated and comprehensive evidence-based health and safety interventions to address the challenge of RTIs in the public transport industry in sub-Saharan Africa. We provide evidence on the magnitude of the problem drawing on the state of mortality and morbidity and reported challenges associated with RTIs in the minibus taxi industry in South Africa as this is the most common mode of public transport in the region.
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Affiliation(s)
- Gugu G Mchunu
- Faculty of Health Sciences, Durban University of Technology, Durban.
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Zagorac S, Markovic-Denic L, Nikolic V. Trends in Road Traffic Crash Fatalities in Belgrade: A Twelve-Year Retrospective Analysis (2010-2021). JOURNAL OF PREVENTION (2022) 2025:10.1007/s10935-025-00846-x. [PMID: 40238034 DOI: 10.1007/s10935-025-00846-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/03/2025] [Indexed: 04/18/2025]
Abstract
The road traffic crashes (RTCs) are one of the significant public health challenges. According to the latest WHO data, about 1.2 million people die as a result of RTCs, making RTCs the main cause of death in many countries. This study assesses road traffic crash (RTC) fatalities in Belgrade, Serbia from 2010 to 2021, utilizing data from the Belgrade Police Department and employing joinpoint regression analysis. Over the period, 1,264 fatalities were recorded with a peak in 2011 (136 deaths) and a reduction to 76 by 2021, indicating a significant annual decrease of -4.4% in mortality rates. Men made up 72.7% of the deaths, with pedestrians being the most affected group (41.0%). There was a notable decline in fatalities among most demographic groups, particularly pedestrians and young adults aged 26-35. The findings highlight a downward trend in RTC mortality, yet the numbers remain concerning. Enhanced enforcement of existing road safety regulations, such as mandatory seat belt use, and targeted measures for vulnerable groups like pedestrians and seniors are recommended to further reduce fatalities.
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Affiliation(s)
- Slavisa Zagorac
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Clinic for Orthopedic Surgery and Traumatology, University Clinical Center of Serbia, Belgrade, Serbia
| | | | - Vladimir Nikolic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
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Govindarajan KK. Relevance of epidemiology data in trauma management. World J Clin Cases 2025; 13:101115. [PMID: 40144483 PMCID: PMC11670019 DOI: 10.12998/wjcc.v13.i9.101115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2024] [Revised: 11/02/2024] [Accepted: 11/26/2024] [Indexed: 12/12/2024] Open
Abstract
Trauma is a major cause of morbidity and mortality across the globe accounting for significant health burden. Relevance of trauma care revolves round prevention, planning and execution of safety regulations. Acquisition of the actual data regarding the type of trauma, affected age group, timings of trauma occurrence, involved part of the body constitute the initial steps in the building of the composite overview of the epidemiology of trauma. In succession, would be the measures directed towards avoidance of trauma and capacity building of trauma center.
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Affiliation(s)
- Krishna Kumar Govindarajan
- Department of Pediatric Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India
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Marzbani B, Moradinazar M, Marzbani B, Rajati F, Khezeli M, Ramazani Y, Tahmasbi M, Aalimehr M. Epidemiological Aspects of Road Accidents in the Middle East and North Africa (MENA) Countries from 1990 to 2019. MIDDLE EAST JOURNAL OF REHABILITATION AND HEALTH STUDIES 2024; 12. [DOI: 10.5812/mejrh-147548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2025]
Abstract
Background: Road accidents are a major public health concern globally and are expected to become the fifth leading cause of death worldwide by 2030. Objectives: This study aimed to compare the consequences of road accidents in the Middle East and North Africa (MENA) region by analyzing data from 21 countries and approximately 400 million people Methods: The data used was from the Global Burden of Diseases (GBD) in 2019, which defines traffic accidents as deaths resulting from external injury causes based on the international classification of diseases (ICD). Results: Road traffic injuries (RTIs) in the MENA region have decreased from 1990 to 2019. Motor vehicles have the highest death rate from RTIs at 15.32 per 100,000, followed by pedestrians at 8.37 per 100,000, motorcyclists at 2.16 per 100,000, and cyclists at 0.35 per 100,000. Saudi Arabia (46.7 per 100,000) and Oman (25.5 per 100,000) have the highest death rates for motor vehicle-related road injuries, while Oman (17.7 per 100,000) and Yemen (12.95 per 100,000) have the highest rates for pedestrian-related road injuries. Conclusions: Given the significant impact of road accidents in the countries of the region, it is crucial to address this issue through various measures. These should include training initiatives, preventive measures, and a review of traffic laws and regulations.
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Xing W, Liu M, Zhang Q, Li L, Mei Y. Research on ecological risk assessment and risk level prediction in the central urban area of Chongqing, China. ENVIRONMENTAL MONITORING AND ASSESSMENT 2024; 196:897. [PMID: 39231811 DOI: 10.1007/s10661-024-12987-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 08/08/2024] [Indexed: 09/06/2024]
Abstract
Complex geological conditions, coupled with urban expansion, resource consumption, and rapid economic development, make the ecological environment of Chongqing's central urban area more vulnerable. To enhance the carrying capacity of resources and the environment in this region, it is significant to scientifically assess the trend of ecological risk changes in Chongqing. The article developed an ecological risk assessment index system for Chongqing, utilizing the "pressure-state-response" framework. The entropy weight method (EWM) is employed to assign weights to each variable, subsequently establishing a grey weighted clustering evaluation model (GWCEM). We evaluated the ecological risks of nine central urban areas in Chongqing from 2005 to 2021 and projected the ecological risk levels and changes from 2022 to 2025. Our research indicates that the comprehensive ranking of influencing factors of ecological risk in Chongqing follows this order: response factor > pressure factor > state factor. Throughout the study period, we observed a decrease in the ecological risk values of Ba'nan, Shapingba, Jiulongpo, Nan'an and Yubei Districts by more than 50%. These decline rates are accelerating and regional differences in ecological risk levels are diminishing. From 2022 to 2025, except Shapingba, Jiangbei, Yuzhong, and Nan'an District which consistently maintained a "low-risk" level, the ecological risk levels of all other areas continue to decrease, aligning with a "low-risk" classification by 2025. Based on the results of ecological risk assessment and ecological risk level prediction, corresponding recommendations are proposed for ecological environment protection and ecological risk management in the central urban area of Chongqing.
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Affiliation(s)
- Wenting Xing
- School of Management Science and Engineering, Chongqing Technology and Business University, Chongqing, 400067, China
- Business School, Sichuan University, Chengdu, 610065, China
| | - Mingzhu Liu
- School of Management Science and Engineering, Chongqing Technology and Business University, Chongqing, 400067, China
| | - Qiao Zhang
- School of Management Science and Engineering, Chongqing Technology and Business University, Chongqing, 400067, China
| | - Lijuan Li
- School of Management Science and Engineering, Chongqing Technology and Business University, Chongqing, 400067, China
| | - Yuanfei Mei
- School of Management Science and Engineering, Chongqing Technology and Business University, Chongqing, 400067, China.
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Jamali-dolatabad M, Sadeghi-bazargani H, Salemi S, Sarbakhsh P. Identifying interactions among factors related to death occurred at the scene of traffic accidents: Application of "logic regression" method. Heliyon 2024; 10:e32469. [PMID: 38961891 PMCID: PMC11219356 DOI: 10.1016/j.heliyon.2024.e32469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 06/02/2024] [Accepted: 06/04/2024] [Indexed: 07/05/2024] Open
Abstract
Aim Traffic accidents are caused by several interacting risk factors. This study aimed to investigate the interactions among risk factors associated with death at the accident scene (DATAS) as an indicator of the crash severity, for pedestrians, passengers, and drivers by adopting "Logic Regression" as a novel approach in the traffic field. Method A case-control study was designed based on the police data from the Road Traffic Injury Registry in northwest of Iran during 2014-2016. For each of the pedestrians, passengers, and drivers' datasets, logic regression with "logit" link function was fitted and interactions were identified using Annealing algorithm. Model selection was performed using the cross-validation and the null model randomization procedure. Results regarding pedestrians, "The occurrence of the accident outside a city in a situation where there was insufficient light" (OR = 6.87, P-value<0.001) and "the age over 65 years" (OR = 2.97, P-value<0.001) increased the chance of DATAS. "Accidents happening in residential inner-city areas with a light vehicle, and presence of the pedestrians in the safe zone or on the non-separate two-way road" combination lowered the chance of DATAS (OR = 0.14, P-value<0.001). For passengers, "Accidents happening in outside the city or overturn of the vehicle" combination (OR = 8.55, P-value<0.001), and "accidents happening on defective roads" (OR = 2.18, P-value<0.001) increased the odds of DATAS; When "driver was not injured or the vehicle was two-wheeled", chance of DATAS decreased for passengers (OR = 0.25, p-value<0.001). The odds of DATAS were higher for "drivers who had a head-on accident, or drove a two-wheeler vehicle, or overturned the vehicle" (OR = 4.03, P-value<0.001). "Accident on the roads other than runway or the absence of a multi-car accident or an accident in a non-residential area" (OR = 6.04, P-value<0.001), as well "the accident which occurred outside the city or on defective roads, and the drivers were male" had a higher risk of DATAS for drivers (OR = 5.40, P-value<0.001). Conclusion By focusing on identifying interaction effects among risk factors associated with DATAS through logic regression, this study contributes to the understanding of the complex nature of traffic accidents and the potential for reducing their occurrence rate or severity. According to the results, the simultaneous presence of some risk factors such as the quality of roads, skill of drivers, physical ability of pedestrians, and compliance with traffic rules play an important role in the severity of the accident. The revealed interactions have practical significance and can play a significant role in the problem-solving process and facilitate breaking the chain of combinations among the risk factors. Therefore, practical suggestions of this study are to control at least one of the risk factors present in each of the identified combinations in order to break the combination to reduce the severity of accidents. This may have, in turn, help the policy-makers, road users, and healthcare professionals to promote road safety through prioritizing interventions focusing on effect size of simultaneous coexistence of crash severity determinants and not just the main effects of single risk factors or their simple two-way interactions.
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Affiliation(s)
- Milad Jamali-dolatabad
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Saman Salemi
- Department of Medicine, Islamic Azad University Tehran Medical Sciences, Tehran, Iran
| | - Parvin Sarbakhsh
- Road Traffic Injury Research Center, Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
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Goldman S, Cohen-Manheim I, Radomislensky I, Savitsky B, Bodas M. Demographic and injury trends for car crash casualties hospitalized in Level I Trauma centers over two decades: data from the National Trauma Registry. Isr J Health Policy Res 2024; 13:27. [PMID: 38811996 PMCID: PMC11135010 DOI: 10.1186/s13584-024-00613-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 05/09/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND During the past two decades, there have been many changes in automotive and medical technologies, road infrastructure, trauma systems, and demographic changes which may have influenced injury outcomes. The aim of this study was to examine injury trends among traffic casualties, specifically private car occupants, hospitalized in Level I Trauma Centers (TC). METHODS A retrospective cohort study was performed based on data from the Israel National Trauma Registry. The data included occupants of private cars hospitalized in all six Level I TC due to a traffic collision related injury between January 1, 1998 and December 31, 2019. Demographic, injury and hospitalization characteristics and in-hospital mortality were analyzed. Chi-squared (X2) test, multivariable logistic regression models and Spearman's rank correlation were used to analyze injury data and trends. RESULTS During the study period, 21,173 private car occupants (14,078 drivers, 4,527 front passengers, and 2,568 rear passengers) were hospitalized due to a traffic crash. The percentage of females hospitalized due to a car crash increased from 37.7% in 1998 to 53.7% in 2019. Over a twofold increase in hospitalizations among older adult drivers (ages 65+) was observed, from 6.5% in 1998 to 15.7% in 2018 and 12.6% in 2019. While no increase was observed for severe traumatic brain injury, a statistically significant increase in severe abdominal and thoracic injuries was observed among the non-Jewish population along with a constant decrease in in-hospital mortality. CONCLUSIONS This study provides interesting findings regarding injury and demographic trends among car occupants during the past two decades. Mortality among private car occupant casualties decreased during the study period, however an increase in serious abdominal and thoracic injuries was identified. The results should be used to design and implement policies and interventions for reducing injury and disability among car occupants.
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Affiliation(s)
- Sharon Goldman
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research , Chaim Sheba Medical Center, 52621, Tel-Hashomer, Ramat Gan, Israel.
| | - Irit Cohen-Manheim
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research , Chaim Sheba Medical Center, 52621, Tel-Hashomer, Ramat Gan, Israel
| | - Irina Radomislensky
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research , Chaim Sheba Medical Center, 52621, Tel-Hashomer, Ramat Gan, Israel
| | - Bella Savitsky
- Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute for Epidemiology and Health Policy Research , Chaim Sheba Medical Center, 52621, Tel-Hashomer, Ramat Gan, Israel
- School of Health Sciences, Ashkelon Academic College, Bella Savitsky, Ashkelon, Israel
| | - Moran Bodas
- Department of Emergnecy & Disaster Management, School of Public Health, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel
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Al-Hajj S, Ariss AB, Bashir R, El Sayed M. Epidemiology of adult injuries: A multi-center study in greater Beirut. Injury 2023; 54:110980. [PMID: 37598070 DOI: 10.1016/j.injury.2023.110980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 06/30/2023] [Accepted: 08/05/2023] [Indexed: 08/21/2023]
Abstract
INTRODUCTION Injury accounts for nearly 4 million deaths and 63 million disabilities annually. The injury burden is disproportionally large in low- and middle-income countries (LMICs), including Lebanon. This study aims to examine the characteristics and patterns of adult injuries presenting at multiple emergency departments (ED) in Lebanon and further identifies factors associated with hospital admission. MATERIALS AND METHODS A retrospective cross-sectional study was conducted on adult patients (aged≥16) who presented with an injury to one of the five participating EDs from June 2017 to May 2018. Pan-Asia Trauma Outcomes Study (PATOS) variables were adopted for data collection. A descriptive analysis was performed, followed by bivariate and multivariate logistic regression to identify injury risk factors for hospital admission. RESULTS A total of 3,716 patients' records were included. Most injuries were sustained by males (62.7%), patients aged between 16 and 35 years (16-25: 28%; 26-35: 22.7%), and above 65 years (15.6%). Most injuries were unintentional (94.9%). Falls were highly prevalent across all age groups (38.8%), more proclaimed among the older adults' population (56-65:52.8%; ≥66:73.7%), followed by struck-by object (23.6%) and transport injuries (10.1%). Upper and lower extremity injuries were common across all ages. Most patients (80.9%) were treated and discharged at the ED, 11.4% were admitted to the hospital, 4.3% were transferred to other trauma care facilities, and 2 patients died in the ED. Factors positively associated with hospital admission included: older age (≥ 56 years); private insurance; spine and lower extremity injuries; fractures, cuts/open wounds, concussion, and organ injuries (p-value≤0.05; OR>1). CONCLUSION Injury is a neglected public health problem in many LMICs, including Lebanon. While youth and the elderly are most affected, injuries occur across all age groups. This study lays the foundation for establishing a population-based injury surveillance system, crucial for designing tailored injury prevention programs to reduce injury-related deaths and disabilities.
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Affiliation(s)
- Samar Al-Hajj
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Abdel-Badih Ariss
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rana Bashir
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mazen El Sayed
- Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
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Wan R, Xia J, Duan F, Min L, Liu T. Global burden and trends of transport injuries from 1990 to 2019: an observational trend study. Inj Prev 2023; 29:418-424. [PMID: 37549986 PMCID: PMC10579470 DOI: 10.1136/ip-2023-044915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/23/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Transport injuries (TIs) are a major cause of global disability-adjusted life-years (DALYs) and mortality. In this study, we aimed to assess the global burden and trends of TIs from 1990 to 2019. METHODS We assessed the annual age-standardised incidence rate (ASIR) and age-standardised DALYs rate of TIs by sex, age, Social Development Index (SDI) and geographical region from 1990 to 2019 from the Global Burden of Disease Study 2019. The changing trends were described by estimated annual percentage changes (EAPCs). RESULTS Globally, in 2019, the ASIR and age-standardised DALYs rates of TIs were 134 6.06/100 000 (95% UI 11 42.6/100 000-157 5.57/100 000) and 97 7.91/100 000 (86 8.91/100 000-107 6.81/100 000), respectively. From 1990 to 2019, the global ASIR of TIs presented significant upwards trends with the EAPC (0.25%, 95% CI 0.19% to 0.31%), and it was significantly increased in the age groups of 15-49 (0.37%, 95% CI 0.29% to 0.45%), 50-69 (0.40%, 95% CI 0.36% to 0.44%) and 70+ (0.22%, 95% CI 0.17% to 0.28%). Prominent increases in ASIR were detected in middle-SDI areas (0.72%, 95% CI 0.57% to 0.87%), low-middle SDI areas (0.66%, 95% CI 0.59% to 0.72%) and low-SDI areas (0.21%, 95% CI 0.17% to 0.26%). The global age-standardised DALYs rate presented downwards trends with the EAPC (-1.27%, 95% CI -1.35% to -1.2%), and it was significantly decreased in all age groups and SDI areas. CONCLUSION Globally, TIs still cause a serious burden, and the incidence has significantly increased, especially in people above the age of 14 and in middle-SDI and low-SDI areas, thus necessitating more attention and health interventions.
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Affiliation(s)
- Rui Wan
- Department of Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Jun Xia
- Department of Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Fangfang Duan
- Department of Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Li Min
- Department of Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Tan Liu
- Department of Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
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Azarbakhsh H, Rezaei F, Dehghani SS, Hassanzadeh J, Dehghani SP, Mirahmadizadeh A. Mortality Rate and Years of Life Lost Due to Road Traffic Accidents in Fars Province, 2004-2019. IRANIAN JOURNAL OF PUBLIC HEALTH 2023; 52:1995-2003. [PMID: 38033827 PMCID: PMC10682593 DOI: 10.18502/ijph.v52i9.13581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/14/2022] [Indexed: 12/02/2023]
Abstract
Background Traffic accidents are one of the most critical health problems and the ninth leading cause of death globally. We aimed to determine the Mortality rate and the number of Years of Life Lost (YLL) due to road traffic accidents. Methods In this retrospective cohort study, mortality rate and YLL due to road traffic accidents were examined in Fars province, central Iran during the years 2004-2019. Mortality statistics were collected through death registration of ministry of health and medical education for Fars Province. Age Standardized mortality Rate (ASR) was calculated and join point regression analysis carried out to examine the trend of YLL rate. Data were analyzed using Excel spreadsheet version 2016 and Join point Regression Program 4.9.0.0. Results During the 16-year study period, 25,858 deaths due to road traffic accidents occurred in the province. 79.2% (20483 cases) were in men, and 33.7% (8703 cases) were aged 15-29 years. Total YLL during the 16-year study period were 458,975 (14.6 per 1000 people) in men, 117,999 (3.8 per 1000 people) in women. According to the join point regression, the 16- year trend of YLL rate due to premature mortality was decreasing: AAPC was -4.9% (95% CI: -8.8 to -0.9; P=0.018) for male, and -3.5% (95% CI: -6.3 to-0.5; P=0.011) for female. Conclusion Considering that the number of deaths, mortality rate and YLL has decreased in Fars province during the 16 years under study. Therefore, because the mortality rate due to road traffic accidents in Iran is higher than the global average, the need for training programs for drivers, compliance with standards and retrofitting of vehicles, road safety, driving supervision and the use of seat belts are essential.
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Affiliation(s)
| | - Fatemeh Rezaei
- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Jafar Hassanzadeh
- Research Center for Health Sciences, Institute of Health, Department of Epidemiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Alireza Mirahmadizadeh
- Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Murillo-Hoyos J, García-Moreno LM, Tinjacá N, Jaramillo C. [Deaths from traffic injuries and social inequality in Colombia, 2019Mortalidade por acidentes de trânsito e desigualdades sociais na Colômbia, 2019]. Rev Panam Salud Publica 2023; 47:e121. [PMID: 37654795 PMCID: PMC10464641 DOI: 10.26633/rpsp.2023.121] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 06/05/2023] [Indexed: 09/02/2023] Open
Abstract
Objective To evaluate the association between social inequalities and deaths from traffic injuries in Colombia in 2019. Methods This ecological study evaluated the association between social inequalities and deaths from traffic injuries among users of the road transport system in Colombia in 2019, based on secondary information sources, using the department level as the administrative and geographic unit of study. A descriptive statistical analysis of health indicators and equity stratifiers was performed. Absolute and relative measures were used to determine social inequality gaps. Results In 2019, 6 580 people died from road traffic injuries in Colombia. The majority of them (82%) were men. The most critical user condition was being a motorcyclist. The age group with the most victims was approximately 30 years old. Departments with populations between 500 000 and 2 000 000 were the most represented. The most critical equity stratifier was the number of registered motorcycles per 100 000 population. Significant inequality gaps between departments were observed. Conclusions Inequalities in deaths from road traffic injuries in Colombia were observed. Policies and actions should focus on helping to reduce identified inequities, resulting in better quality of life, well-being, and health for the population.
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Affiliation(s)
- Jackeline Murillo-Hoyos
- Escuela de Ingeniería Civil y GeomáticaUniversidad del ValleCaliColombiaEscuela de Ingeniería Civil y Geomática. Universidad del Valle, Cali, Colombia.
| | - Lina M. García-Moreno
- Escuela de Ingeniería Civil y GeomáticaUniversidad del ValleCaliColombiaEscuela de Ingeniería Civil y Geomática. Universidad del Valle, Cali, Colombia.
| | - Natalia Tinjacá
- Organización Panamericana de la SaludBogotáColombiaOrganización Panamericana de la Salud. Bogotá, Colombia.
| | - Ciro Jaramillo
- Escuela de Ingeniería Civil y GeomáticaUniversidad del ValleCaliColombiaEscuela de Ingeniería Civil y Geomática. Universidad del Valle, Cali, Colombia.
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12
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Xu Y, Chen M, Yang R, Wumaierjiang M, Huang S. Global, Regional, and National Burden of Road Injuries from 1990 to 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16479. [PMID: 36554366 PMCID: PMC9779128 DOI: 10.3390/ijerph192416479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 11/30/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: Understanding occurrence can help formulate effective preventative laws and regulations. However, the most recent global burden and road injuries (RIs) trends have not been reported. This study reports the burden of RIs globally from 1990 to 2019. (2) Methods: RIs data were downloaded from the Global Burden of Disease 2019. Incidence, deaths, and disability-adjusted life years (DALYs) described the trend and burden of RIs. We calculated age-standardized rates (ASRs) and estimated annual percentage change (EAPC) for the above indexes to evaluate the temporal trend of RIs. We evaluated the social-demographic index (SDI) with epidemiological RI parameters and reported proportions of age-standardized rates due to RI. (3) Results: In 2019, the global incidence of RIs reached 103.2 million. The EAPC of RI incidence increased, whereas deaths and DALYs decreased. Age-standardized incident rate (ASIR) was highest in low-middle SDI regions, age-standardized death rate (ASDR) was high in middle SDI regions, and age-standardized DALYs increased in low SDI regions. The highest accident rates were found in those aged 20-24 years old. Cyclist injuries were the leading RIs (34%), though pedestrian and motor vehicle accidents were the leading cause of death (37.4%, 37.6%) and DALYs (35.7%, 32.3%), respectively. (4) Conclusions: Over the past 30 years, RIs incidence increased annually, though death and DALY rates decreased. RIs places a considerable burden on public health in low SDI countries. Data should be used to develop and implement effective measures to reduce the burden of RIs.
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Affiliation(s)
- Yifan Xu
- Department of Orthopedics, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an 710049, China
| | - Meikai Chen
- Department of Intensive Care Unit, The Affiliated Drum Tower Hospital, Medical School, Nanjing University, Nanjing 210093, China
| | - Ruitong Yang
- Department of Orthopedics, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an 710049, China
| | - Muhemaiti Wumaierjiang
- Department of Orthopedics, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an 710049, China
| | - Shengli Huang
- Department of Orthopedics, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an 710049, China
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13
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Rezapur-Shahkolai F, Afshari M, Doosti-Irani A, Bashirian S, Maleki S. Interventions to prevent road traffic injuries among pedestrians: a systematic review. Int J Inj Contr Saf Promot 2022; 29:533-549. [PMID: 35776527 DOI: 10.1080/17457300.2022.2089685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Road traffic injuries (RTIs) are a serious public health problem and are an important cause of disability and death worldwide. A significant proportion of traffic injuries and fatalities are among pedestrians. Reviewing and evaluating related interventions can be a practical step to implementing appropriate methods to prevent RTIs among pedestrians, a highly vulnerable group of road users. The search of articles was conducted in the electronic databases of Scopus, PubMed, ISI, Safety Lit, and CDC. Other papers were also reviewed using forward citation and backward citation. The search strategy was for studies examined from the first years of database creation until January 10, 2021, in all languages in journals with matched judgment according to the type of population, type of interventions, comparators, and results. Joanna Briggs Institute (JBI) checklists were used to determine articles' quality and assess possible biases depending on the type of study. The initial search resulted in finding 16,272 abstracts. Finally, 25 studies, including 17 randomized clinical trials (RCTs) studies, seven studies pretest/post-test interventions (PPI), and one study controlled pretest/post-test interventions (cPPI) met the inclusion criteria. Among these preventive interventional studies, 20 studies were conducted in high-income countries, three were in lower middle-income countries, one study was in upper middle-income country, and only one study was conducted in a low-income country. Most interventional studies in the field of prevention of RTIs (15 studies) had an educational/behavioral approach, designed to change pedestrian behavior and the use of this approach was also effective in improving pedestrian behavior. The legislation/law enforcement approach was used in one study and two studies used an engineering/technology approach. In studies with an engineering approach after engineering reforms, pedestrian injuries in children decreased by 37.5%. In seven studies, multifaceted interventions were used. The interventional studies that used this approach were able to improve pedestrian safe behavior. The majority of studies were based on educational/behavioral approaches and pedestrians' behavior improved notably. In addition, the majority of interventional studies were conducted in countries with high income levels. Therefore, programming for preventive interventions to attenuate RTIs is highly important in low/middle-income countries to reduce the risk of injury to vulnerable road users. These findings can be applied by policy-makers to develop educational, engineering, environmental, and law enforcement interventions and attenuate injuries sustained by pedestrians.
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Affiliation(s)
- Forouzan Rezapur-Shahkolai
- Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.,Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.,Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Afshari
- Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.,Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amin Doosti-Irani
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.,Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Saeed Bashirian
- Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.,Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shahnaz Maleki
- Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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14
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Al-Hajj S, Farran S, Sibai AM, Hamadeh RR, Rahimi-Movaghar V, Al-Raddadi RM, Sadeghian F, Ghodsi Z, Alhajyaseeh W, Rmeileh NMA, Mokdad AH, GBD 2019 Collaborators. Injury burden in individuals aged 50 years or older in the Eastern Mediterranean region, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. THE LANCET. HEALTHY LONGEVITY 2022; 3:e253-e262. [PMID: 35515813 PMCID: PMC8979829 DOI: 10.1016/s2666-7568(22)00038-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Injury poses a major threat to health and longevity in adults aged 50 years or older. The increased life expectancy in the Eastern Mediterranean region warrants a further understanding of the ageing population's inevitable changing health demands and challenges. We aimed to examine injury-related morbidity and mortality among adults aged 50 years or older in 22 Eastern Mediterranean countries. METHODS Drawing on data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we categorised the population into adults aged 50-69 years and adults aged 70 years and older. We examined estimates for transport injuries, self-harm injuries, and unintentional injuries for both age groups, with sex differences reported, and analysed the percentage changes from 1990 to 2019. We reported injury-related mortality rates and disability-adjusted life-years (DALYs). The Socio-demographic Index (SDI) and the Healthcare Access and Quality (HAQ) Index were used to better understand the association of socioeconomic factors and health-care system performance, respectively, with injuries and health status in older people. Healthy life expectancy (HALE) was compared with injury-related deaths and DALYs and to the SDI and HAQ Index to understand the effect of injuries on healthy ageing. Finally, risk factors for injury deaths between 1990 and 2019 were assessed. 95% uncertainty intervals (UIs) are given for all estimates. FINDINGS Estimated injury mortality rates in the Eastern Mediterranean region exceeded the global rates in 2019, with higher injury mortality rates in males than in females for both age groups. Transport injuries were the leading cause of deaths in adults aged 50-69 years (43·0 [95% UI 31·0-51·8] per 100 000 population) and in adults aged 70 years or older (66·2 [52·5-75·5] per 100 000 population), closely followed by conflict and terrorism for both age groups (10·2 [9·3-11·3] deaths per 100 000 population for 50-69 years and 45·7 [41·5-50·3] deaths per 100 000 population for ≥70 years). The highest annual percentage change in mortality rates due to injury was observed in Afghanistan among people aged 70 years or older (400·4% increase; mortality rate 1109·7 [1017·7-1214·7] per 100 000 population). The leading cause of DALYs was transport injuries for people aged 50-69 years (1798·8 [1394·1-2116·0] per 100 000 population) and unintentional injuries for those aged 70 years or older (2013·2 [1682·2-2408·7] per 100 000 population). The estimates for HALE at 50 years and at 70 years in the Eastern Mediterranean region were lower than global estimates. Eastern Mediterranean countries with the lowest SDIs and HAQ Index values had high prevalence of injury DALYs and ranked the lowest for HALE at 50 years of age and HALE at 70 years. The leading injury mortality risk factors were occupational exposure in people aged 50-69 years and low bone mineral density in those aged 70 years or older. INTERPRETATION Injuries still pose a real threat to people aged 50 years or older living in the Eastern Mediterranean region, mainly due to transport and violence-related injuries. Dedicated efforts should be implemented to devise injury prevention strategies that are appropriate for older adults and cost-effective injury programmes tailored to the needs and resources of local health-care systems, and to curtail injury-associated risk and promote healthy ageing. FUNDING Bill & Melinda Gates Foundation.
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Affiliation(s)
- Samar Al-Hajj
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Sarah Farran
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Abla M Sibai
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Randah R Hamadeh
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Farideh Sadeghian
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Zahra Ghodsi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Wael Alhajyaseeh
- Qatar Transportation and Traffic Safety Center, and Department of Civil and Architectural Engineering, College of Engineering, Qatar University, Doha, Qatar
| | - Niveen M Abu Rmeileh
- Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
| | - Ali H Mokdad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - GBD 2019 Collaborators
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
- Qatar Transportation and Traffic Safety Center, and Department of Civil and Architectural Engineering, College of Engineering, Qatar University, Doha, Qatar
- Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
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15
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Dávila-Cervantes CA. Road injury burden in Mexico 1990 to 2019: Secondary data analysis from the Global Burden of Disease Study. ACCIDENT; ANALYSIS AND PREVENTION 2021; 160:106316. [PMID: 34332290 DOI: 10.1016/j.aap.2021.106316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 06/30/2021] [Accepted: 07/16/2021] [Indexed: 02/05/2023]
Abstract
Road injuries have been a major cause of premature mortality and disability in Mexico. The objective of this paper is to report the findings from the Global Burden of Disease study (GBD-2019) on road injuries in Mexico at a national and subnational scale from 1990 to 2019, and to assess the association between road injury burden and the socio-demographic index. Following the 2019 Global Burden of Disease study road injury mortality, premature mortality, the years lived with disability and disability-adjusted life-years (DALYs) are reported. While the number of deaths from road injuries increased between 1990 and 2019, the age-standardized mortality rates declined. Pedestrian road injuries and motor vehicle road injuries accounted for 8 of every 10 deaths from road injury in 2019. Road injury mortality and DALY rates decreased nationally, but stagnated since 2011. The road injury burden was higher for men in all age groups. Pedestrian and motor vehicle road injuries caused the highest DALY rate in both males and females. There was no significant association between the SDI and the road injury age-standardized DALY rates. This study presents a comprehensive report of road injury burden of disease in Mexico. Mexico continues to have an incomplete, fragmented and poorly enforced legislative framework, with a large diversity between its 32 states. Thus, an integrated legislative and juridical effort is needed to continue reducing the road injury disease burden, which is tailored for specific age groups, vulnerable road users and high-burden areas.
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16
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Sabry HA, Abou Zeid A, Salem M. Percentage of Injuries, and Related Factors Among a Group of Medical Students in Cairo University: A Cross-Sectional Study. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.5933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: There has been a lack of data on injuries in young adults, including university students, in particular medical students.
AIM: The current study was conducted to explore the percentage, and related factors of injuries among a group of medical students, who constitute an important risk group for accidents and injuries.
METHODS: This exploratory cross-sectional study was conducted in Kasr Al-ainy Medical School. A convenient sample of medical students was chosen. 1300 survey questionnaires were distributed along all academic years, 807 from them were completely retrieved. The questionnaire form was adopted from “Health behavior survey among university students in low- and middle-income countries questionnaire.” Data entry and analysis were carried out using SPSS 21.0.
RESULTS: One-quarter reported having a form of injury last year. Falling was the most nominated cause of injuries by the participant students (5,31.3%). Only those who “perceived” their general health as “well” reported being injured significantly more than those who perceived their general health as poor, with a p value = 0.006 and odds ratio of 1.6 (1.1–2.2). Taking drugs was the only factor significantly determining how the injury happened; whether it is intentional or unintentional with a p = 0.01 highlighting that about one-third (5, 31.3%) of those who were intentionally injured were taking drugs.
CONCLUSION: Two factors were identified which will increase the understanding of public health of injuries in university communities to design programs for injury prevention programs specifically targeting medical students.
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17
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Kalantari AH, Monavar Yazdi S, Hill T, Mohammadzadeh Moghaddam A, Ayati E, Sullman MJM. Psychosocial factors associated with the self-reported frequency of cell phone use while driving in Iran. PLoS One 2021; 16:e0249827. [PMID: 33882099 PMCID: PMC8059850 DOI: 10.1371/journal.pone.0249827] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/25/2021] [Indexed: 11/18/2022] Open
Abstract
Cell phone use while driving is a common contributing factor in thousands of road traffic injuries every year globally. Despite extensive research investigating the risks associated with cell phone use while driving, social media campaigns to raise public awareness and a number of laws banning phone use while driving, this behaviour remains prevalent throughout the world. The current study was conducted in Iran, where road traffic injuries are the leading causes of death and disability, and where drivers continue to use their cell phones, despite legislative bans restricting this behaviour. A total of 255 drivers in the city of Mashhad (male = 66.3%; mean age = 30.73 years; SD = 9.89) completed either an online or a paper-based survey assessing the self-reported frequency of using a cell phone while driving. Psychosocial factors contributing to cell phone use while driving and support for legislation restricting this behaviour, as well as the Big Five personality traits, were also measured. Overall, the results showed that almost 93% of drivers use their cell phones while driving at least once a week, with 32.5% reporting they always use their cell phones while driving. Ordinal logistic regression revealed that the presence of a child passenger, age, perceived benefits and risks of using cell phones while driving, as well as the perceived ability to drive safely while using a cell phone, were strongly associated with the frequency of cell phone use while driving. As for personality traits-extraversion, agreeableness and conscientiousness significantly predicted the frequency of cell phone use in this sample of Iranian drivers.
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Affiliation(s)
| | | | - Tetiana Hill
- Hertfordshire Business School, University of Hertfordshire, Hatfield, United Kingdom
| | - Abolfazl Mohammadzadeh Moghaddam
- Department of Civil Engineering, Ferdowsi University of Mashhad, Mashhad, Iran
- Techno-Economic Road Safety Research Center, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Esmaeel Ayati
- Techno-Economic Road Safety Research Center, Ferdowsi University of Mashhad, Mashhad, Iran
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18
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Cislaghi B, Weber AM, Gupta GR, Darmstadt GL. Gender equality and global health: intersecting political challenges. J Glob Health 2020; 10:010701. [PMID: 32257161 PMCID: PMC7101083 DOI: 10.7189/jogh.10.010701] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Women’s and men’s health outcomes are different. Some differences are biological, related to male and female sex, while others are related to their gender. Sex- and gender-related issues require different solutions, but policy makers lack straightforward heuristic strategies to identify gender-related health inequities. Methods Using 169 causes of disability-adjusted life years (DALYs) from the 2017 Global Burden of Disease, we calculated the female-to-male (f:m) and male-to-female (m:f) ratios of global DALYs, rank-ordered the ratios by size and calculated the proportion of all-cause DALYs that each cause explained, separately for males and females 15-49 years old. Gender-related vs sex-related causes were categorised using literature on the drivers for the 15 causes with highest f:m and m:f ratios. Results Causes of DALYs with high m:f ratios appear to be gendered and include: road injuries, interpersonal violence, and drowning – totaling 12.4% of men’s (15-49 years) all-cause DALYs. However, causes of DALYs with high f:m ratios are more likely a mix of sex-related and gender-related factors – including headache disorders, depressive disorders, and dietary iron deficiency – totaling 13.4% of women’s (15-49 years) all-cause DALYs. Ratios vary by age, geography and Socio-demographic Index. Conclusions Gender-related vs sex-related causes were categorised using available literature on the drivers for selected causes, illustrating that sex-disaggregated data represents a mix of social and biological influences. This analysis offers a model that policy makers can use to uncover potential gender inequalities in health, including intersections with other social factors. From it, new challenges emerge for global health policy makers and practitioners willing to address them. Global health actors will need to achieve a balance between the two agendas of global health and gender equality.
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Affiliation(s)
- Beniamino Cislaghi
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Ann M Weber
- School of Community Health Sciences, University of Nevada, Reno, Nevada, USA
| | | | - Gary L Darmstadt
- Department of Pediatrics and Center for Population Health Sciences, Stanford University School of Medicine, Stanford, California, USA
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19
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Soori H, Khorasani-Zavareh D. Road traffic injuries measures in the Eastern Mediterranean Region: findings from the Global Status Report on Road Safety - 2015. J Inj Violence Res 2019; 11:149-158. [PMID: 31101799 PMCID: PMC6646828 DOI: 10.5249/jivr.v11i2.1122] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 04/27/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The Eastern Mediterranean Region has the second highest road traffic fatality rate in the world. This article presents the epidemiology of road traffic injuries and the preventive measures in Eastern Mediterranean Region taken by the different World Health Organization member states compared to the rest of the world. METHODS This is a secondary data analysis addressing the Global Status Report on Road Safety published by the World Health Organization in 2015. Data are from 180 countries covering 6.97 billion people of the world's population, of which 21 Eastern Mediterranean Region of World Health Organization member states with about 595 million population were included and were analyzed. From 22 countries in the region, 21 are presented and Syria has not reported any data on road traffic injuries. RESULTS Eastern Mediterranean Region member states contribute to 9.69% of all global fatal road traffic injuries (19.9 per 100 000 population compared to the same rate in the European region with 9.3), while these countries account for 7.4% of the world's population and have about 5.6% of the world's vehicles on their roads. More than 90% of the Eastern Mediterranean Region countries have passed mandatory seat-belt laws for both front-seat and rear-seat passengers and making helmet use obligatory; and only 27% have child restraint laws; half percent have an emergency room injury surveillance system. All countries have a national drink-driving law; and certain speed limits but there is no distinction between rural and urban areas, and the latter lack adequate speed restrictions. CONCLUSIONS Although the Eastern Mediterranean Region member states have some important preventive measures recommended by World Health Organization, considerable efforts are still needed to optimize the enforcement of existing road safety laws. The maximum urban speed limit should be reduced in many countries. Sufficient attention should be paid to the needs of pedestrians, cyclists and motorcyclists, who together make up about 50% of Eastern Mediterranean Region road traffic deaths.
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Affiliation(s)
| | - Davoud Khorasani-Zavareh
- Department of Health in Emergencies and Disasters, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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20
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Gupta GR, Oomman N, Grown C, Conn K, Hawkes S, Shawar YR, Shiffman J, Buse K, Mehra R, Bah CA, Heise L, Greene ME, Weber AM, Heymann J, Hay K, Raj A, Henry S, Klugman J, Darmstadt GL. Gender equality and gender norms: framing the opportunities for health. Lancet 2019; 393:2550-2562. [PMID: 31155276 DOI: 10.1016/s0140-6736(19)30651-8] [Citation(s) in RCA: 143] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 02/28/2019] [Accepted: 03/06/2019] [Indexed: 11/24/2022]
Abstract
The Sustainable Development Goals offer the global health community a strategic opportunity to promote human rights, advance gender equality, and achieve health for all. The inability of the health sector to accelerate progress on a range of health outcomes brings into sharp focus the substantial impact of gender inequalities and restrictive gender norms on health risks and behaviours. In this paper, the fifth in a Series on gender equality, norms, and health, we draw on evidence to dispel three myths on gender and health and describe persistent barriers to progress. We propose an agenda for action to reduce gender inequality and shift gender norms for improved health outcomes, calling on leaders in national governments, global health institutions, civil society organisations, academic settings, and the corporate sector to focus on health outcomes and engage actors across sectors to achieve them; reform the workplace and workforce to be more gender-equitable; fill gaps in data and eliminate gender bias in research; fund civil-society actors and social movements; and strengthen accountability mechanisms.
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Affiliation(s)
| | | | | | | | - Sarah Hawkes
- University College London, Centre for Gender and Global Health, London, UK
| | - Yusra Ribhi Shawar
- Bloomberg School of Public Health and Paul H Nitze School of Advanced International Studies, Johns Hopkins University, Baltimore, MD, USA
| | - Jeremy Shiffman
- Bloomberg School of Public Health and Paul H Nitze School of Advanced International Studies, Johns Hopkins University, Baltimore, MD, USA
| | | | - Rekha Mehra
- Independent Consultant, Economist and Gender Specialist, Washington, DC, USA
| | | | - Lori Heise
- Department of Population, Family and Reproductive Health, Bloomberg School of Public Health and School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | | | - Ann M Weber
- Department of Pediatrics and the Center for Population Health Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Jody Heymann
- Fielding School of Public Health, University of California Los Angeles, CA, USA
| | | | - Anita Raj
- Department of Medicine, Center on Gender Equity and Health University of California San Diego, La Jolla, CA, USA
| | - Sarah Henry
- Department of Pediatrics and the Center for Population Health Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Jeni Klugman
- Women and Public Policy Program, Harvard Kennedy School, Cambridge, MA, USA
| | - Gary L Darmstadt
- Department of Pediatrics and the Center for Population Health Sciences, Stanford University School of Medicine, Stanford, CA, USA
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21
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Heise L, Greene ME, Opper N, Stavropoulou M, Harper C, Nascimento M, Zewdie D. Gender inequality and restrictive gender norms: framing the challenges to health. Lancet 2019; 393:2440-2454. [PMID: 31155275 DOI: 10.1016/s0140-6736(19)30652-x] [Citation(s) in RCA: 558] [Impact Index Per Article: 93.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/01/2019] [Accepted: 03/06/2019] [Indexed: 02/07/2023]
Abstract
Gender is not accurately captured by the traditional male and female dichotomy of sex. Instead, it is a complex social system that structures the life experience of all human beings. This paper, the first in a Series of five papers, investigates the relationships between gender inequality, restrictive gender norms, and health and wellbeing. Building upon past work, we offer a consolidated conceptual framework that shows how individuals born biologically male or female develop into gendered beings, and how sexism and patriarchy intersect with other forms of discrimination, such as racism, classism, and homophobia, to structure pathways to poor health. We discuss the ample evidence showing the far-reaching consequences of these pathways, including how gender inequality and restrictive gender norms impact health through differential exposures, health-related behaviours and access to care, as well as how gender-biased health research and health-care systems reinforce and reproduce gender inequalities, with serious implications for health. The cumulative consequences of structured disadvantage, mediated through discriminatory laws, policies, and institutions, as well as diet, stress, substance use, and environmental toxins, have triggered important discussions about the role of social injustice in the creation and maintenance of health inequities, especially along racial and socioeconomic lines. This Series paper raises the parallel question of whether discrimination based on gender likewise becomes embodied, with negative consequences for health. For decades, advocates have worked to eliminate gender discrimination in global health, with only modest success. A new plan and new political commitment are needed if these global health aspirations and the wider Sustainable Development Goals of the UN are to be achieved.
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Affiliation(s)
- Lori Heise
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins School of Nursing, Baltimore, MD, USA.
| | | | - Neisha Opper
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - Maria Stavropoulou
- Programme on Gender Equality and Social Inclusion, Overseas Development Institute, London, UK
| | - Caroline Harper
- Programme on Gender Equality and Social Inclusion, Overseas Development Institute, London, UK
| | - Marcos Nascimento
- Programa de Posgraduação em Saúde da Criança e da Mulher, Instituto Fernandes Figueira-Fiocruz, Rio de Janeiro, RJ, Brazil
| | - Debrework Zewdie
- School of Public Health and Health Policy, City University of New York, New York, NY, USA
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22
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Gates M. A new normal: addressing gender to improve health. Lancet 2019; 393:2373-2374. [PMID: 31155278 DOI: 10.1016/s0140-6736(19)30989-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 04/25/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Melinda Gates
- The Bill & Melinda Gates Foundation, Seattle, WA 98109, USA.
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23
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Sengoelge M, Leithaus M, Braubach M, Laflamme L. Are There Changes in Inequalities in Injuries? A Review of Evidence in the WHO European Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16040653. [PMID: 30813329 PMCID: PMC6406953 DOI: 10.3390/ijerph16040653] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 02/17/2019] [Accepted: 02/19/2019] [Indexed: 11/16/2022]
Abstract
Decreases in injury rates globally and in Europe in the past decades, although encouraging, may mask previously reported social inequalities between and within countries that persist or even increase. European research on this issue has not been systematically reviewed, which is the aim of this article. Between and within-country studies from the WHO European Region that investigate changes in social inequalities in injuries over time or in recent decades were sought in PubMed, Scopus, and Web of Science. Of the 27 studies retained, seven were cross-country and 20 were country-specific. Twelve reported changes in inequalities over time and the remaining 15 shed light on other aspects of inequalities. A substantial downward trend in injuries is reported for all causes and cause-specific ones—alongside persisting inequalities between countries and, in a majority of studies, within countries. Studies investigate diverse questions in different population groups. Depending on the social measure and injury outcome considered, many report inequalities in injuries albeit to a varying degree. Despite the downward trends in risk levels, relative social inequalities in injuries remain a persisting public health issue in the European Region.
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Affiliation(s)
- Mathilde Sengoelge
- Department of Public Health Sciences, Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18 A, 171 77 Stockholm, Sweden.
| | - Merel Leithaus
- Department of International Health, Maastricht University, Universiteitssingel 40, 6229 ET Maastricht, The Netherlands.
| | - Matthias Braubach
- WHO European Centre for Environment and Health, Platz der Vereinten Nationen 1, D-53113 Bonn, Germany.
| | - Lucie Laflamme
- Department of Public Health Sciences, Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18 A, 171 77 Stockholm, Sweden.
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