Citation

Chalmers D, Pless IB. Inj. Prev. 2001; 7(2): 81-82.

Copyright

(Copyright © 2001, BMJ Publishing Group)

DOI

10.1136/ip.7.2.81

PMID

11428568

PMCID

PMC1730714

Abstract

The report issued by the United Nation's Children's Fund (UNICEF) in February, 2001, by the Innocenti Research Centre in Florence, Italy, has attracted much attention.1 One of us (BP) promptly wrote a letter to the editor of his local newspaper deploring the tiny space it gave to the UNICEF report relative to that provided to a single case of meningitis and one possible case of Ebola virus. The letter concluded that it was evident that infectious diseases attract the public attention far more than do injuries. It went on to castigate government ministers for doing so little about injury prevention. Needless to say, the letter was watered down and lost much of its punch. Perhaps as a consequence it failed to capture the attention or arouse the ire of the Canadian federal or provincial health ministers. No doubt the same would have happened in New Zealand.

Both of us could have played up our country's relatively low ranking to try to make the point that we needed, as do other countries, a national focus for injury prevention. But, viewing other data in the same report, Canada does not appear quite so bad, whereas New Zealand does. Thus the statistics in this carefully crafted report (see book review, 166) offer a bag of mixed messages.

Assuming the numbers are all accurate, and truly comparable (assumptions that probably should not be made with great confidence) what comparisons should we make? The data featured most prominently are the injury death rates per 100 000 children ages 1–14 for 1991–95 (figure 1 in the UNICEF document). These show countries with a fivefold difference. Sweden sets the pace with a rate of 5.2 while Korea trails with 25.6. Of the 26 countries represented in this figure, the United States is fourth from the bottom, with Canada and New Zealand not far behind.

The statistics for the 1970s, however, tell a different story. At that time, Sweden, Greece, and Spain shared top positions on the ladder, while the bottom rungs were occupied by Canada, Germany, and Mexico. In the 1970s governments and citizens of most countries were not yet aware of injuries as a health problem and had thought little about their prevention. So this date is a reasonable starting point for what should have been a race for laggard countries to try to catch up to the front runners....