Injuries and violence: the global magnitude Etienne Krug
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Injuries and violence: the global magnitude Etienne Krug Director, Violence and Injury Prevention and Disability World Health Organization Global mortality by causes Deaths (millions) 6 5 4 3 Malaria TB 2 1 HIV 0 Global public health priorities Violence and injuries Global mortality by causes Deaths (millions) 6 5 Violence 4 Malaria 3 TB 2 1 Unint. Injuries HIV 0 Global public health priorities Violence and injuries Leading causes of injury deaths Road traffic Other crashes 21% 23% War 3% Poisonings 6% Violence 11% Falls 8% Fires Self-inflicted injuries 6% 15% Drownings 7% Leading causes of death 2004 Total 2004 Total 2030 % % 1 Ischaemic heart disease 12.2 1 Ischaemic heart disease 14.2 2 Cerebrovascular disease 9.7 2 Cerebrovascular disease 12.1 7.0 3 Chronic obstructive pulmonary disease 5.1 4 Low er respiratory infections 3.8 Road traffic accidents 3.6 3 Low er respiratory infections 4 Chronic obstructive pulmonary disease 5 Diarrhoeal diseases 3.6 5 6 HIV/AIDS 3.5 6 Trachea, bronchus, lung cancers 3.4 7 Tuberculosis 2.5 7 Diabetes mellitus 3.3 8 Trachea, bronchus, lung cancers 2.3 8 Hypertensive heart disease 2.1 9 Road traffic accidents 2.2 9 Stomach cancer 1.9 10 Prematurity and low birth w eight 2.0 10 HIV/AIDS 1.8 11 Neonatal infections and other 1.9 11 Nephritis and nephrosis 1.6 1.9 12 Self-inflicted injuries 1.5 13 Malaria 1.7 13 Liver cancer 1.4 14 Hypertensive heart disease 1.7 14 Colon and rectum cancer 1.4 15 Birth asphyxia and birth trauma 1.5 15 Oesuphagus cancer 1.3 16 Self-inflicted injuries 1.4 16 Violence 1.2 17 Stomach cancer 1.4 17 Alzheimer and other dementias 1.2 18 Cirrhosis of the liver 1.3 18 Cirrhosis of the liver 1.2 19 Nephritis and nephrosis 1.3 19 Breast cancer 1.1 20 Colon and rectum cancers 1.1 20 Tuberculosis 1.0 22 Violence 1.0 12 Diabetes mellitus 8.6 Leading causes of deaths 2004 vs. 2030 Total 2004 Total 2030 % % 1 Ischaemic heart disease 12.2 1 Ischaemic heart disease 14.2 2 Cerebrovascular disease 9.7 2 Cerebrovascular disease 12.1 7.0 3 Chronic obstructive pulmonary disease 5.1 4 Low er respiratory infections 3.8 Road traffic accidents 3.6 3 Low er respiratory infections 4 Chronic obstructive pulmonary disease 5 Diarrhoeal diseases 3.6 5 6 HIV/AIDS 3.5 6 Trachea, bronchus, lung cancers 3.4 7 Tuberculosis 2.5 7 Diabetes mellitus 3.3 8 Trachea, bronchus, lung cancers 2.3 8 Hypertensive heart disease 2.1 9 Road traffic accidents 2.2 9 Stomach cancer 1.9 10 Prematurity and low birth w eight 2.0 10 HIV/AIDS 1.8 11 Neonatal infections and other 1.9 11 Nephritis and nephrosis 1.6 1.9 12 Self-inflicted injuries 1.5 13 Malaria 1.7 13 Liver cancer 1.4 14 Hypertensive heart disease 1.7 14 Colon and rectum cancer 1.4 15 Birth asphyxia and birth trauma 1.5 15 Oesuphagus cancer 1.3 16 Self-inflicted injuries 1.4 16 Violence 1.2 17 Stomach cancer 1.4 17 Alzheimer and other dementias 1.2 18 Cirrhosis of the liver 1.3 18 Cirrhosis of the liver 1.2 19 Nephritis and nephrosis 1.3 19 Breast cancer 1.1 20 Colon and rectum cancers 1.1 20 Tuberculosis 1.0 22 Violence 1.0 12 Diabetes mellitus 8.6 90000 9 80000 8 70000 7 60000 6 50000 5 40000 4 30000 3 20000 2 Fatalities 10000 1 Fatalities/100,000 persons 0 0 1961 1966 1971 1976 1981 Year 1986 1991 1996 2001 Fatalities/100,000 persons Fatalities Road traffic deaths in India 1961-2001 04 years Rank 514 years 1529 years 3044 years 45-59 years ≥60 years All Ages 1 Perinatal conditions Lower respiratory infections HIV/AIDS HIV/AIDS Ischaemic heart disease Ischaemic heart disease Ischaemic heart disease 2 Lower respiratory infections Road traffic injuries Road traffic injuries Tuberculosis Cerebrovascular disease Cerebrovascular disease Cerebrovascular disease 3 Diarrhoeal diseases HIV/AIDS Maternal conditions Road traffic injuries HIV/AIDS Chronic obstructive pulmonary disease Lower respiratory infections 4 Childhood diseases Drownings Self-inflicted injuries Maternal conditions Tuberculosis Lower respiratory infections HIV/AIDS 5 Malaria Childhood diseases Tuberculosis Ischaemic heart disease Chronic obstructive pulmonary disease Trachea, bronchus, lung cancers Chronic obstructive pulmonary disease 6 Congenital anomalies Fires Violence Self-inflicted injuries Trachea, bronchus, lung cancers Diabetes mellitus Perinatal conditions 7 HIV/AIDS Tuberculosis Lower respiratory infections Violence Cirrhosis of the liver Hypertensive heart disease Diarrhoeal diseases 8 Protein-energy malnutrition Protein-energy malnutrition Drownings Cerebrovascular disease Road traffic injuries Stomach cancer Tuberculosis 9 Syphilis Meningitis Fires Lower respiratory infections Self-inflicted injuries Tuberculosis Trachea, bronchus, lung cancers 10 Meningitis Leukaemia War injuries Cirrhosis of the liver Stomach cancer Colon and rectum cancers Road traffic injuries Congenital anomalies Ischaemic heart disease Poisonings Liver cancer Nephritis and nephrosis Childhood diseases 11 Drownings 12 Road traffic injuries Falls Poisonings Fires Lower respiratory infections Alzheimer and other dementias Diabetes mellitus 13 Tuberculosis Poisonings Falls War injuries Diabetes mellitus Cirrhosis of the liver Malaria 14 Endocrine disorders Violence Leukaemia Drownings Breast cancer Liver cancer Hypertensive heart disease 15 Fires Leishmaniasis Rheumatic heart disease Liver Cancer Hypertensive heart disease Oesophagus cancer Self-inflicted injuries Regional differences in injury death rates AFRO 104.33 AMRO 67.08 EMRO 93.31 EURO 89.32 SEARO 116.58 WPRO 68.78 World 89.86 Regional differences: The Eastern Mediterranean is the region with the highest road traffic and war injury death rates the 3rd highest death rates for burns and for drowning Wide ranging health consequences • Injuries • Disability • Mental consequences • Depression • Anxiety, insomnia, etc • Suicide • HIV and other STDs • Unwanted pregnancies •Behavioural changes • smoking • alcohol • drugs • Abortion + consequences • Cancer • Cardio-vascular diseases • Other NCDs Economic impact Road traffic crashes: 1 - 3% of GDP – Examples: Bangladesh 1.6%, Uganda 2.3%, USA 2.3%, 11 HICs (excluding USA) 1.4%, Malawi 5%. – China, RTIs cost $12.5 billion: Four times the total public health budget. In LMICs, economic cost of RTIs alone estimated at nearly US$100 billion. – Twice the sum of all development assistance. Violence: 1 - 2% of GDP Thank you ! kruge@who.int
