Injury: A Global Perspective Steve Amaefuna B.A. University of Wisconsin School of Medicine and Public Health Presented April 23, 2017, New Orleans, LA, USA 2018 ThinkFirst Conference on Inury Prevention

14,000 people die every day due to injury Source: WHO Injuries and Violence the Facts , 2014

Causes of Global Injury Mortality Falls Suicide Other unintentional injury Road traffic injury Although due to a number of causes including…nearly 25% of global injury mortality results from traffic accidents Source: WHO Global Health Estimates, 2014

Road Traffic Injury Leading cause of death in individuals ages 15-29 3% of Global GDP Will be 7th overall leading cause of death by 2030 Source: WHO Global Status Report on Road Safety 2015

Trends In Global Road Traffic Mortality Global plateau in 2007 4% increase in population 16% increase in registered vehicles Improved legislation Speeding Drunk-driving Helmet use Seat-belts Child restraints Social marketing campaigns Click It or Ticket Still No Decline Source: WHO Global Status Report on Road Safety 2015

One of the main reasons lies in the fact that there is distinct imbalance in the distribution of road traffic mortality 90% of global traffic injury deaths occur in low/middle income countries Low/middle income countries only account for 54% of registered vehicles Source: WHO Global Status Report on Road Safety 2015

Trends In Global Road Traffic Mortality 9.2 17.3 8.1 This unfortunate pattern grows clearer when you compare fatality rates between different regions of the globe Center blue is the international average which was 17.4 in 2013 When you compare that to regions with much higher rates like Africa as well as regions with much lower rates like Europe However, when you compare Africa to Europe, the difference in fatality rates almost doubles 9.2 between Africa and world 8.1 between Europe and World 17.3 between Africa and Europe Large disparity seen in death rates between high and low/middle income countries Source: WHO Global Status Report on Health Safety, 2015

Trends In Global Road Traffic Mortality United States Not only is there a difference in regional fatality rates themselves, but you can also see a distinct difference in the overall trajectory of fatality rates in high vs low/middle income countries Motorization in low/middle income countries is outpacing the creation of road safety initiatives Sources: Cambodia: http://tinyurl.com/mezjmqh. India: http://tinyurl.com/odgmf4s. USA: Fatality Analysis Reporting System (FARS)

Global Traumatic Brain Injury 60% of global TBI is due to road traffic incidents (RTIs) 20 – 30% due to falls 10% due to violence Source: Hyder AA, Wunderlich CA, Puvanachandra P, Gururaj G, Kobusingye OC. The impact of traumatic brain injuries: a global perspective. NeuroRehabilitation. 2007;22(5):341-353.

Global Traumatic Brain Injury Netherlands 51% USA 13.7% Mexico 43% India 59% Brazil 41% Comparative rates of TBI due to RTI around the world Sources: Peeters, Wouter et al. “Epidemiology of Traumatic Brain Injury in Europe.” Acta Neurochirurgica 157.10 (2015): 1683–1696. PMC. Web. 10 Apr. 2017. Hyder AA, Wunderlich CA, Puvanachandra P, Gururaj G, Kobusingye OC. The impact of traumatic brain injuries: A global perspective. NeuroRehabilitation. 2007;22(5):341-353. Taylor CA, Bell JM, Breiding MJ, Xu L. Traumatic Brain Injury-Related Emergency Department Visits, Hospitalizations, and Deaths - United States, 2007 and 2013. Morbidity and mortality weekly report. Surveillance summaries. Mar 17 2017;66(9):1-16.

Understanding The Gaps Accessibility of emergency services Varying levels of post-crash care Lack of centralized emergency services number Inconsistent road-traffic accident data collection Deficits in education and law enforcement ThinkFirst International Global surge in road infrastructure and vehicle use

Sharing information on the international experience with TBI Addressing The Gaps Data collection and analysis is essential in assessing the progress of interventions and tailoring prevention efforts Sharing information on the international experience with TBI

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