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Neill R, Hernández AL, Koon AD, Bachani AM. Translating global evidence into local implementation through technical assistance: a realist evaluation of the Bloomberg philanthropies initiative for global Road safety. Global Health 2024; 20:42. [PMID: 38725015 PMCID: PMC11084027 DOI: 10.1186/s12992-024-01041-z] [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: 12/20/2023] [Accepted: 04/22/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Traffic-related crashes are a leading cause of premature death and disability. The safe systems approach is an evidence-informed set of innovations to reduce traffic-related injuries and deaths. First developed in Sweden, global health actors are adapting the model to improve road safety in low- and middle-income countries via technical assistance (TA) programs; however, there is little evidence on road safety TA across contexts. This study investigated how, why, and under what conditions technical assistance influenced evidence-informed road safety in Accra (Ghana), Bogotá (Colombia), and Mumbai (India), using a case study of the Bloomberg Philanthropies Initiative for Global Road Safety (BIGRS). METHODS We conducted a realist evaluation with a multiple case study design to construct a program theory. Key informant interviews were conducted with 68 government officials, program staff, and other stakeholders. Documents were utilized to trace the evolution of the program. We used a retroductive analysis approach, drawing on the diffusion of innovation theory and guided by the context-mechanism-outcome approach to realist evaluation. RESULTS TA can improve road safety capabilities and increase the uptake of evidence-informed interventions. Hands-on capacity building tailored to specific implementation needs improved implementers' understanding of new approaches. BIGRS generated novel, city-specific analytics that shifted the focus toward vulnerable road users. BIGRS and city officials launched pilots that brought evidence-informed approaches. This built confidence by demonstrating successful implementation and allowing government officials to gauge public perception. But pilots had to scale within existing city and national contexts. City champions, governance structures, existing political prioritization, and socio-cultural norms influenced scale-up. CONCLUSION The program theory emphasizes the interaction of trust, credibility, champions and their authority, governance structures, political prioritization, and the implement-ability of international evidence in creating the conditions for road safety change. BIGRS continues to be a vehicle for improving road safety at scale and developing coalitions that assist governments in fulfilling their role as stewards of population well-being. Our findings improve understanding of the complex role of TA in translating evidence-informed interventions to country-level implementation and emphasize the importance of context-sensitive TA to increase impact.
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Affiliation(s)
- Rachel Neill
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street Suite E8527, Baltimore, MD, 21205, USA.
| | - Angélica López Hernández
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street Suite E8527, Baltimore, MD, 21205, USA
| | - Adam D Koon
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street Suite E8527, Baltimore, MD, 21205, USA
| | - Abdulgafoor M Bachani
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street Suite E8527, Baltimore, MD, 21205, USA
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Jin Y, Ye P, Tian M, Peden M, Ivers R, Zhang L, Xiong S, Cai W, Duan L, Brown J. A scoping review of national policies for child road injury in China. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 46:101079. [PMID: 38726348 PMCID: PMC11079522 DOI: 10.1016/j.lanwpc.2024.101079] [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: 10/11/2023] [Revised: 02/12/2024] [Accepted: 04/16/2024] [Indexed: 05/12/2024]
Abstract
There has been limited examination of child road injury policies. This study aims to systematically characterize national policies relevant to child road safety in China over the past two decades and identify potential gaps based on the WHO child road safety framework. As a scoping review, this study searched for national policies for child road safety on the websites of government agencies. A total of 22,487 policies were searched, of which 103 policies issued by 37 institutions, were included in the analysis, including 12 policies jointly developed by multiple agencies. Mapping identified policies to strategies in the WHO framework, most WHO strategies requiring legislation were found to be in place in China and to fully meet the intent of the WHO recommendation. The single exception was in the area of child restraints which was deemed to not be fully covered due to a lack of eligible policies on enforcement of child restraint use laws. Two strategies requiring standards were fully covered; eight strategies requiring policy support were partially or not covered, mainly related to equipping emergency vehicles with child-appropriate medical equipment. Enhancing school bus safety was identified as a policy focus area in China beyond those recommended by the WHO framework. This study identified three areas for improvement: (1) strengthening road safety policies targeting children, (2) strengthening enforcement of legislation, e.g., child restraint use, and (3) increasing multiple-sector cooperation on policy formulation. Funding Ye Jin is supported by the Scholarship from the George Institute for Global Health and Tuition Fee Scholarships from University of New South Wales.
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Affiliation(s)
- Ye Jin
- The George Institute for Global Health, University of New South Wales, Australia
- The National Center for Non-communicable and Chronic Disease Control and Prevention, China Center for Disease Control and Prevention, China
| | - Pengpeng Ye
- The National Center for Non-communicable and Chronic Disease Control and Prevention, China Center for Disease Control and Prevention, China
| | - Maoyi Tian
- The George Institute for Global Health, University of New South Wales, Australia
- School of Public Health, Harbin Medical University, China
| | - Margie Peden
- The George Institute for Global Health, UK
- Faculty of Medicine, Imperial College of London, UK
| | - Rebecca Ivers
- School of Public Health and Community Medicine, University of New South Wales, Australia
| | - Li Zhang
- China University of Political Science and Law, China
| | - Shangzhi Xiong
- The George Institute for Global Health, University of New South Wales, Australia
| | - Weicong Cai
- The George Institute for Global Health, University of New South Wales, Australia
- Shenzhen Center for Chronic Disease Control, China
| | - Leilei Duan
- The National Center for Non-communicable and Chronic Disease Control and Prevention, China Center for Disease Control and Prevention, China
| | - Julie Brown
- The George Institute for Global Health, University of New South Wales, Australia
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Delaney PG, De Vos S, Eisner ZJ, Friesen J, Hingi M, Mirza UJ, Kharel R, Moussally J, Smith N, Slingers M, Sun J, Thullah AH. Challenges, opportunities, and priorities for tier-1 emergency medical services (EMS) development in low- and middle-income countries: A modified Delphi-based consensus study among the global prehospital consortium. Injury 2024:111522. [PMID: 38599953 DOI: 10.1016/j.injury.2024.111522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 03/26/2024] [Accepted: 03/30/2024] [Indexed: 04/12/2024]
Abstract
INTRODUCTION Though the disease burden addressable by prehospital and out-of-hospital emergency care(OHEC) spans communicable diseases, maternal conditions, chronic conditions and injury, the single largest disability-adjusted life year burden contributor is injury, primarily driven by road traffic injuries(RTIs). Establishing OHEC for RTIs and other common emergencies in low- and middle-income countries(LMICs) where the injury burden is disproportionately greatest is a logical first step toward more comprehensive emergency medical services(EMS). However, with limited efforts to formalize and expand existing informal bystander care networks, there is a lack of consensus on how to develop and maintain bystander-driven Tier-1 EMS systems in LMICs. Resultantly, Tier-1 EMS development is fragmented among non-governmental organizations and the public sector globally. METHODS A steering committee coordinated a 9-round, modified Delphi-based expert discussion to identify current challenges, opportunities, and priorities in Tier-1 EMS development globally. 11 panelists represented seven Global Prehospital Consortium(GPC) member organizations with a mean 9.57 years of organizational Tier-1 EMS development/implementation experience(median = 9 years). The consortium represents the largest collaboration between organizations directing Tier-1 EMS programs globally across 12 countries on 3 continents(Americas, sub-Saharan Africa, and South Asia) with 22,000 first responders. RESULTS The GPC identified seven priority areas for Tier-1 EMS development: infrastructure/operations, communication, education/training, impact evaluation, financing, governance/legal, and transportation/equipment. A high level of consensus exists regarding priorities for investigation, including Tier-1 responder density/distribution, Tier-1 patient data variable standardization for trauma registries/quality improvement, dispatch technologies/protocols, modular curricula, broader cost-effectiveness and impact evaluation indices capturing secondary impacts of EMS, standardizing legal protections for first responders, and transportation/equipment standards. DISCUSSION Consensus is necessary to avoid duplicative and disorganized efforts due to the fragmented nature of parallel Tier-1 EMS efforts globally. A Delphi-like multi-round expert discussion among the members of the largest collaboration between organizations directing Tier-1 EMS programs globally generated relevant priorities to direct future efforts.
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Guan B, Anderson DB, Chen L, Feng S, Zhou H. Global, regional and national burden of traumatic brain injury and spinal cord injury, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. BMJ Open 2023; 13:e075049. [PMID: 37802626 PMCID: PMC10565269 DOI: 10.1136/bmjopen-2023-075049] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/20/2023] [Indexed: 10/09/2023] Open
Abstract
OBJECTIVES To evaluate the most up-to-date burden of traumatic brain injury (TBI) and spinal cord injury (SCI) and analyse their leading causes in different countries/territories. DESIGN An analysis of Global Burden of Disease (GBD) data. SETTING The epidemiological data were gathered from GBD Results Tool (1 January, 1990─31 December 2019) covering 21 GBD regions and 204 countries/ territories. PARTICIPANTS Patients with TBI/SCI. MAIN OUTCOMES AND MEASURES Absolute numbers and age-standardised rates/estimates of incidence, prevalence and years lived with disability (YLDs) of TBI/SCI by location in 2019, with their percentage changes from 1990 to 2019. The leading causes (eg, falls) of TBI/SCI in 204 countries/territories. RESULTS Globally, in 2019, TBI had 27.16 million new cases, 48.99 million prevalent cases and 7.08 million YLDs. SCI had 0.91 million new cases, 20.64 million prevalent cases and 6.20 million YLDs. Global age-standardised incidence rates of TBI decreased significantly by -5.5% (95% uncertainty interval -8.9% to -3.0%) from 1990 to 2019, whereas SCI had no significant change (-6.1% (-17.3% to 1.5%)). Regionally, in 2019, Eastern Europe and High-income North America had the highest burden of TBI and SCI, respectively. Nationally, in 2019, Slovenia and Afghanistan had the highest age-standardised incidence rates of TBI and SCI, respectively. For TBI, falls were the leading cause in 74% (150/204) of countries/territories, followed by pedestrian road injuries (14%, 29/204), motor vehicle road injuries (5%, 11/204), and conflict and terrorism (2%, 4/204). For SCI, falls were the leading cause in 97% (198/204) of countries/territories, followed by conflict and terrorism (3%, 6/204). CONCLUSIONS Global age-standardised incidence rates of TBI have decreased significantly since 1990, whereas SCI had no significant change. The leading causes of TBI/SCI globally were falls, but variations did exist between countries/territories. Policy-makers should continue to prioritise interventions to reduce falls, but priorities may vary between countries/territories.
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Affiliation(s)
- Bin Guan
- Department of Orthopaedics, Qilu Hospital of Shandong University, Shandong University Centre for Orthopaedics, Advanced Medical Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China
| | - David B Anderson
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Lingxiao Chen
- Department of Orthopaedics, Qilu Hospital of Shandong University, Shandong University Centre for Orthopaedics, Advanced Medical Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China
- Sydney Musculoskeletal Health, The Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Shiqing Feng
- Department of Orthopaedics, Qilu Hospital of Shandong University, Shandong University Centre for Orthopaedics, Advanced Medical Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China
- The Second Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China
| | - Hengxing Zhou
- Department of Orthopaedics, Qilu Hospital of Shandong University, Shandong University Centre for Orthopaedics, Advanced Medical Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P.R. China
- Center for Reproductive Medicine, Shandong University, Jinan, Shandong, P.R. China
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Garcia RM, Ghotme KA, Arynchyna-Smith A, Mathur P, Koning M, Boop F, Peterson D, Sheneman N, Johnson WD, Park KB, Griswold D, Aukrust CG, Barthélemy EJ, Ibbotson G, Blount JP, Rosseau GL. Global Neurosurgery: Progress and Resolutions at the 75th World Health Assembly. Neurosurgery 2023; 93:496-501. [PMID: 37010299 DOI: 10.1227/neu.0000000000002472] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/17/2023] [Indexed: 04/04/2023] Open
Abstract
Neurosurgical advocates for global surgery/neurosurgery at the 75th World Health Assembly gathered in person for the first time after the COVID-19 pandemic in Geneva, Switzerland, in May 2022. This article reviews the significant progress in the global health landscape targeting neglected neurosurgical patients, emphasizing high-level policy advocacy and international efforts to support a new World Health Assembly resolution in mandatory folic acid fortification to prevent neural tube defects. The process of developing global resolutions through the World Health Organization and its member states is summarized. Two new global initiatives focused on the surgical patients among the most vulnerable member states are discussed, the Global Surgery Foundation and the Global Action Plan on Epilepsy and other Neurological Disorders. Progress toward a neurosurgery-inspired resolution on mandatory folic acid fortification to prevent spina bifida-folate is described. In addition, priorities for moving the global health agenda forward for the neurosurgical patient as it relates to the global burden of neurological disease are reviewed after the COVID-19 pandemic.
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Affiliation(s)
- Roxanna M Garcia
- Department of Neurological Surgery, Northwestern University, Chicago , Illinois , USA
| | - Kemel A Ghotme
- Translational Neuroscience Research Lab, Faculty of Medicine, Universidad de La Sabana, Chía , Colombia
- Pediatric Neurosurgery, Department of Neurosurgery, Fundacion Santa Fe de Bogota, Bogota , Colombia
| | | | - Priyanka Mathur
- McGaw Feinberg School of Medicine, Northwestern University, Chicago , Illinois , USA
| | | | - Frederick Boop
- Division of Pediatric Neurosurgery, University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | | | | | - Walter D Johnson
- Center for Global Surgery, Loma Linda University, California , USA
| | - Kee B Park
- Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Harvard Medical School, Boston , Massachusetts , USA
| | - Dylan Griswold
- Stanford University School of Medicine, Stanford , California , USA
- NIHR Group on Neurotrauma, Cambridge , United Kingdom
| | - Camilla G Aukrust
- Department of Neurosurgery, Oslo University Hospital, Oslo , Norway
- Department of Community Medicine and Global Health, University of Oslo, Oslo , Norway
| | - Ernest J Barthélemy
- Division of Neurosurgery, SUNY Downstate Health Sciences University, Brooklyn, New York , USA
| | | | - Jeffrey P Blount
- Division of Pediatric Neurosurgery, University of Alabama at Birmingham, Birmingham , Alabama , USA
| | - Gail L Rosseau
- Department of Neurosurgery, George Washington University School of Medicine and Health Sciences, Washington , District of Columbia , USA
- Barrow Neurological Institute, Phoenix , Arizona , USA
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Montenegro-Martínez G, Agudelo-Cifuentes MC, Muñoz-Rodriguez DI. Mortality due to traffic accidents in Colombia: Profiles of pedestrians and cyclists, 1998-2019. F1000Res 2023; 12:360. [PMID: 37576539 PMCID: PMC10415722 DOI: 10.12688/f1000research.131431.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/19/2023] [Indexed: 08/15/2023] Open
Abstract
Background: Traffic accidents are an important issue for public health and a threat for sustainable development, with pedestrians and cyclists having been recognized as the most vulnerable actors on the streets. The objective of this study was to analyze the profiles of pedestrians and cyclists who died as a result of traffic accidents in Colombia during the 1998-2019 period. Methods: An observational and descriptive study, with the deaths due to traffic accidents in Colombia between 1998 and 2019 as data source. Secondary data were taken from the Vital statistics of Colombia (EEVV), published by Departamento Administrativo Nacional de Estadística (DANE). A trend analysis of the number of deaths during the period under study was performed, and such number was examined against sex to identify potential differences. Multiple correspondence analysis was employed to elaborate the profile of pedestrians and cyclists who die due to traffic accidents. Three profiles were prepared for each road actor: a global profile, one for 1998, and another for 2019. Results: The mortality profiles are different for pedestrians and cyclists, and, in turn, there are also demographic, geographic, and socioeconomic conditions in each type of road actor, which determine higher mortality risks. High population density, younger age group in the cyclists and adults among the pedestrians, low schooling levels and absence of health insurance are suggested as key factors in these profiles. Related to sex, for men is not possible to establish a profile. Women's cases are commonly related to health insurance, age, and population density. Conclusions: Several contextual and demographic characteristics in pedestrians and cyclists allow delimiting mortality profiles. The profiles that were identified suggest the need to articulate road safety policies with other social and development policies in order to coordinate and integrate intersectoral actions that reduce mortality in these road actors.
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Montenegro Martínez G, Arias-Castro CE, Silva Sánchez DC, Cardona-Arango D, Segura-Cardona Á, Muñoz-Rodríguez DI, Gutiérrez Ossa J, Henao Villegas S. [Social inequalities related to road traffic mortality]. GACETA SANITARIA 2023; 37:102313. [PMID: 37352821 DOI: 10.1016/j.gaceta.2023.102313] [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: 09/02/2022] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE To synthesize the social inequalities related to mortality from traffic accidents reported in scientific publications. METHOD A scoping review following the PRISMA-ScR guide was carried out. Using the MesH vocabulary, we systematically searched for articles in English, Portuguese and Spanish published in the EBSCO, Scielo, Scopus, Ovid, and PubMed databases. RESULTS We identified 47,790 records in the initial search, of which 35 articles met the selection criteria. Nine out ten publications are in high-income countries; there is a greater interest in analyzing mortality in occupants and drivers of vehicles and motorcyclists. Half of the publications use race-ethnicity and geolocation as socioeconomic position variables. The articles included in this review indicate that groups of people with low socioeconomic positions have higher mortality due to traffic accidents. CONCLUSIONS The highest mortality from traffic accidents occurs in people with low socioeconomic positions which suggests the development of road safety actions from a comprehensive, integrative perspective and linked to other political agendas to reduce their incidence by 2030. Although road traffic fatalities are higher in low and middle-income countries, few publications are available in these countries. It is necessary to strengthen the research capacities in these countries.
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Affiliation(s)
| | | | | | | | | | | | - Jahir Gutiérrez Ossa
- Facultad de Ciencias Administrativas y Económicas, Universidad CES, Medellín, Colombia
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He L, Liu C, Shan X, Zhang L, Zheng L, Yu Y, Tian X, Xue B, Zhang Y, Qin X, Wang C, Zhang K, Luo B. Impact of high temperature on road injury mortality in a changing climate, 1990-2019: A global analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 857:159369. [PMID: 36228793 DOI: 10.1016/j.scitotenv.2022.159369] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/23/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Previous studies have shown that extreme heat likely increases the risk of road injuries. However, the global burden of road injuries due to high temperature and contributing factors remain unclear. This study aims to characterize the global, regional and national burden of road injuries due to high temperature from 1990 to 2019. METHODS Based on the Global Burden of Disease (GBD) study 2019, we obtained the numbers and age-standardized mortality rates (ASMR) and age-standardized disability-adjusted life years (DALY) rates (ASDR) of the road injury due to high temperature at global, regional, and national levels from 1990 to 2019. The world is divided into five climate zones according to the average annual temperature of each country: tropical, subtropical, warm temperate, cold temperate, and boreal. We used the generalized additive models (GAM) to model the trends of road injuries globally and by region. RESULTS Globally, between 1990 and 2019, the deaths of road injury attributable to high temperature increased significantly from 20,270 (95% uncertainty interval [UI], 7836 to 42,716) to 28,396 (95% UI, 13,311 to 51,178), and the DALYs increased from 1,169,309 (95% UI, 450,834 to 2,491,075) to 1,414,527 (95% UI, 658,347 to 2,543,613). But the ASMR and the ASDR slightly decreased by 8.49% and 13.16%, respectively. The burden of road injury death attributable to high temperature remained high in low SDI and tropical regions. In addition, road transport infrastructure investment per inhabitant is associated with the burden of road injuries attributable to high temperature. CONCLUSIONS Globally, the ASMR and ASDR for road injuries attributable to high temperature decreased from 1990 to 2019, but the absolute death and DALYs continued to increase. Thus, concerning global warming, implementation of prevention and interventions to reduce road injuries from heat exposure should be stressed globally.
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Affiliation(s)
- Li He
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China
| | - Ce Liu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China
| | - Xiaobing Shan
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China
| | - Ling Zhang
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China
| | - Ling Zheng
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China
| | - Yunhui Yu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China
| | - Xiaoyu Tian
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China
| | - Baode Xue
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China
| | - Yu Zhang
- Department of Civil and Environmental Engineering, University of South Florida, Tampa, FL 33620, USA
| | - Xiao Qin
- Department of Civil and Environmental Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI 53201, USA
| | - Cara Wang
- Department of Civil and Environmental Engineering, Rensselaer Polytechnic Institute, Troy, NY 12211, USA
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, NY 12144, USA.
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China; Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Bureau, Shanghai 200030, People's Republic of China; Shanghai Typhoon Institute, China Meteorological Administration, Shanghai 200030, People's Republic of China.
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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: 0.5] [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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Scarr JP, Jagnoor J. Identifying opportunities for multisectoral action for drowning prevention: a scoping review. Inj Prev 2022; 28:585-594. [DOI: 10.1136/ip-2022-044712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/26/2022] [Indexed: 11/05/2022]
Abstract
BackgroundDrowning is a complex health issue, where global agendas call for greater emphasis on multisectoral action, and engagement with sectors not yet involved in prevention efforts. Here, we explored the conceptual boundaries of drowning prevention in peer-review and grey literature, by reviewing the contexts, interventions, terminologies, concepts, planning models, and sector involvement, to identify opportunities for multisectoral action.MethodsWe applied scoping review method and have reported against Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews checklist. We searched four electronic databases for peer-reviewed articles published on 1 January 2005 and 31 December 2020 and five databases for grey literature published on 1 January 2014 and 31 December 2020. We applied the search term “drowning,” and charted data addressing our research questions.ResultsWe included 737 peer-reviewed articles and 68 grey documents. Peer-publications reported situational assessments (n=478, 64.86%) and intervention research (n=259, 35.14%). Drowning was reported in the context of injury (n=157, 21.30%), commonly in childhood injury (n=72, 9.77%), mortality studies (n=60, 8.14%) and in grey documents addressing adolescent, child, environmental, occupational and urban health, refugee and migrant safety and disaster. Intervention research was mapped to World Health Organization recommended actions. The leading sectors in interventions were health, leisure, education and emergency services.ConclusionAlthough drowning is often described as a major health issue, the sectors and stakeholders involved are multifarious. The interventions are more often initiated by non-health sectors, meaning multisectoral action is critical. Framing drowning prevention to reinforce cobenefits for other health and development agendas could strengthen multisectoral action. Greater investment in partnerships with non-health sectors, encouraging joint planning and implementation, and creating systems for increased accountability should be a priority in future years.
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