Too high a price: Injuries and accidents in London Caroline Lowdell, Justine Fitzpatrick, Ruth Wallis, Jenny Mindell and Bobbie Jacobson

Report aims To provide a comprehensive view of injuries and accidents in London –range of causes –range of data sources To estimate the economic cost of injury and accidents to London Highlight opportunities for prevention through interventions that are known to work

Types of injuries looked at Road traffic accidents Fires Poisonings (including suicide, deliberate self- harm and accidental) Falls Assault and homicide

National policy context Saving lives: Our healthier nation Task Force report: Preventing accidental injury - priorities for action National Service Framework for older people ? The Children’s National Service Framework ? Health inequalities - Government delivery plans and Cross-Cutting Spending Reviews

Outputs available Full report Executive summary A new tool for accessing local data at local authority level A national and local policy overview and Full report on the economic costs of injury and accidents to London

The toll to Londoners average number per year (~ )

Cost of injuries £m’s

London in Europe Standardised mortality ratios for accidents. London = 100 (Source: Megapoles)

London in England Age-standardised mortality rates - types of accidents (Source: ONS)

London in England Age-standardised mortality rates - road traffic accidents (Source: ONS)

Inequalities within London Headline points Deprived communities are more likely to be killed or seriously injured in most, but not all, types of injuries The very young and the very old are accidents’ most affected victims Young men are predominant victims of many specific types of injury e.g. RTAs, poisonings, assault Alcohol and drugs play a major role in many types of preventable injury

Inequalities within London Age standardised mortality for accidents, suicide, and homicide (Source: ONS)

Inequalities within London Ambulance call outs for fire incidents (Source: LAS)

Special factors at work in the Capital Fires Certain household types are at greatest risk of fire –converted flats and rented accommodation –accommodation in bad condition –young household head –lone parent households –households in financial difficulty A high proportion of people living alone and high rates of drug use –both are more likely to die or be injured if fire breaks out

Inequalities within London Age standardised admission and mortality rates for accidental falls, aged 65 and over. (Source: HES) AdmissionsMortality

Inequalities within London Age standardised admission rates for accidental falls, all ages. (Source: HES)

Inequalities within London Road traffic accident rate by location and by drivers residence. (Source: LAAU) LocationDrivers residence

Special factors at work in the Capital Road traffic accidents Congestion and low traffic speeds - collisions may occur at lower speeds Heavy traffic flows in residential and commercial areas are a hazard to pedestrians Car ownership is lower than average - more people are travelling on foot High levels and use of public transport may reduce the road traffic death toll compared to elsewhere

Types of injury Ambulance call outs for assault. (Source: LAS) N = 30,000

Types of injury Admissions for accidental falls. (Source: HES)

Summary of recommendations The report makes 19 recommendations including:  Cross-government as well as London leadership to overcome the fragmentation of effort.  A national strategy to reduce alcohol and in particular to reduce the legal blood alcohol limit from 80 to 50 mg/100ml.  Better targeted prevention work across London by Fire, Police and Health Services, Community Safety Partnerships and Schools to tackle areas and groups suffering the greatest inequalities.  The introduction of a mandatory common data set for monitoring injuries agreed across all agencies which includes agreed measures of ethnicity and severity.

Outputs available Full report Executive summary A new tool for accessing local data at local authority level A national and local policy overview and Full report on the economic costs of injury and accidents to London