Road injury high in Global Burden of Disease

The Lancet has published the new Global Burden of Disease study, the largest ever global report on the causes and distribution of disease, injury and other health risk factors. The study was led by the Institute for Health Metrics & Evaluation, at the University of Washington, with funding from the Bill & Melinda Gates Foundation, and provides a picture of how life expectancy and causes of death and disability have changed over twenty years from 1990 to 2010.

The study confirms the rise in road traffic injury - with deaths increasing by almost half over two decades - to be the tenth leading cause of death overall. It also finds a shift from communicable to 'non communicable' disease, partly through some success in combating early childhood disease and partly through demographic change, with an increase in the overall share of DALYS (Disability Adjusted Life Years) lost due to premature death and disability amongst young adults as compared to child aged under five.

Some of the findings relating to road injury:

-  Road-traffic crashes were the number one killer of young people and accounted for nearly a third of the world injury burden - a total of 76 million DALYS in 2010, up from 57 million in 1990.

- The fraction of global deaths due to injuries (5.1 million deaths) was marginally higher in 2010 (9.6%) compared with two decades earlier (8.8%). This was driven by a 46% rise in deaths worldwide due to road traffic accidents (1.3 million in 2010) and a rise in deaths from falls.


The study also says:

"To put road injury in context, it accounts for 53% more burden than tuberculosis. Road injury shows a classic inverted U-shaped pattern with the largest DALY rates and highest rank as a cause of burden in regions that are upper low-income or middle-income. Nevertheless, even in the demographically and epidemiologically advanced regions, road injury is in the top 16 causes. The distribution of road injury by specific subcause is also important for policy: in seven developing regions more than 40% of road injury deaths are in pedestrians including all sub-Saharan African regions, south and east Asia, and Andean Latin America. Motorised two-wheel vehicles account for more than 20% of road injury deaths in southeast and east Asia and tropical Latin America. The local patterns of road injury and publications on road safety argue that most road injury is preventable. Some high-income countries such as Australia have been able to reduce the death rate from road injuries by 43·7% since 1990, providing a population level demonstration that many deaths are preventable. Various global initiatives on road safety have been launched but they remain relatively weakly funded and are yet to have a demonstrable effect on the rising burden from road injury globally. Continued attention from both the health sector and the transport sector will be needed to address this growing challenge".