The role of public health in injury prevention

1. The role of public health in injury prevention Roberto Bertollini MD MPH Director Special Programme on Health and Environment WHO Regional Office for Europe

2. 1 death 30 hospital admissions 300 emergency department visits ?? self treated or general practice visits 1. Burden and costsInjuries are the third leading cause of death in Europe, killing 800 000 people every year For every fatal injury, an estimated 30 people are hospitalized and 300 require outpatient treatment in hospital emergency departments

3. They not only experience premature deaths, but also live longer with disability 1. Burden and costsThe burden of injuries disproportionately affects younger people Source: WHO, Global burden of disease 2002 rev.3

4. 1. Burden and costsNowhere in the world is the difference between poorer and wealthier countries in mortality from injury as high as in Europe People in low- and middle-income countries (LMIC) are at 4 times more likely to die from injuries than people in high-income countries (HIC). The achievements of the HIC, which are among the safest in the world, indicates that closing this gap IS possible. Standardized mortality rate from all injuries in the WHO European Region for both sexes, 2002

5. The health care cost of injuries is estimated at € 189 billion (Range € 81-296 billion) 1. Burden and costsThe cost of injuries to society is enormous Societal costs have only begun to be mapped out: • for RTIs, these have been estimated at 2% of national GDP • for violence, only a few studies are available. In the United Kingdom, societal costs of domestic violence were estimated at nearly € 33 billion per year (1.9% UK GDP)

6. 2. Opportunities for preventionHuge savings of lives could be achieved if all countries in the Region equalled the performance of the safest Potential life saving in Europe could reach 500 000 lives Baseline period 2000-2002 or three most recent years. Population 849,496,543

7. €1 spent on smoke alarms saves €69 €1 spent on child safety seats saves €32 €1 spent on prevention counsellingby paediatricians saves €10 saves €19 €1 spent on home visitation and parent education against child abuse €1 spent on road safety improvements saves €3 €1 spent on universal licensing of handguns saves €79 2. Opportunities for preventionMany cost-effective measures exist Selected estimates of savings from investing in prevention Sources: Working to prevent and control injury in the United States- Fact Book for the year 2000. Atlanta, GA National Center for Injury Prevention and Control, 2000. Caldwell RA. The costs of child abuse vs. child abuse prevention: Michigan’s experience. East Lasing, MI, Michigan Children’s Trust Fund, 1992. Chapedelaine A, Maurice P. Firearms injury prevention and gun control in Canada. Canadian Medical Association Journal, 1996, 155: 1285-1289.

8. Public Health Advocacy Services for victims Research Engaging other sectors Policy Prevention & control Injury surveillance, evaluation 3. The way forward Redefining the role of public health for injury prevention Providing services for victims is only one of the roles that the health sector can play. Other roles offer further opportunities to reduce the burden of injuries.

9. 3. The way forwardResolution on prevention of injuries in the European Region (EUR/RC55/R9) Member States and the WHO have taken commitments to: • Develop national plans for injury prevention • Improve national surveillance • Strengthen national capacity to respond to the burden of injury and provide services for victim • Advocate effective injury prevention activities • Promote good practice and the exchange of knowledge across the Region • Prioritize research in primary prevention and trauma care • Strengthen partnerships across sectors and stakeholders • Report back on progress achieved in 2008

10. Thank you for your attention!http://www.euro.who.int/violenceinjury

11. Thank you for your attention! http://www.euro.who.int/violenceinjury