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Abstract
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Injuries, alongside communicable and chronic non-communicable diseases, represent significant public health challenges impacting global population health (1). The World Health Organization (WHO) reports that in 2019, approximately 4.4 million deaths were attributed to unintentional injuries and violence, constituting 8% of all deaths worldwide (2-3). Moreover, each year, countless individuals suffer from non-fatal injuries. The Global Burden of Disease Study 2019 (GBD 2019) highlights this concern, revealing an injury-specific standardized mortality rate of 54.65 per 100,000 and injury-specific standardized disability-adjusted life years (DALYs) of 3168.70 per 100,000. The economic impact of injuries is profound, costing billions of dollars annually in healthcare, lost productivity, and law enforcement across various nations. Particularly in China, a rapidly developing country, injuries pose a significant health threat. In 2021, China’s injury mortality rate stood at 46.90 per 100,000, representing 6.61% of total deaths. Notably, the rate of injury mortality was higher among males and in rural areas. Unsettlingly, injuries have become the leading cause of death for children aged 1–14 in China (4).
There is compelling evidence that injuries are both preventable and manageable. Consequently, injury prevention and control are garnering global attention. The United Nations and World Health Assembly have proposed several resolutions focusing on road traffic safety, drowning prevention, and child injury prevention. Increasingly, countries and regions are formulating action plans for injury prevention and control, elevating it as a critical public health priority. Furthermore, there is a consensus on the implementation of evidence-based strategies for injury prevention and control, adopting public health-related methodologies. The public health approach to injury prevention is multidisciplinary, underscoring the need for multisectoral collaboration to effectively tackle injury issues. This approach encompasses four essential steps: conducting injury surveillance, analyzing risk factors, developing effective interventions, and reviewing implementation and residual problems. China’s efforts in injury prevention and control trace back to the 1980s. Health sectors have been instrumental in injury data collection and surveillance, applying epidemiological techniques to health policy, and initiating high-quality comprehensive healthcare services. Additionally, these sectors are involved in multisectoral collaborations, implementing preventive and control practices targeting key injury types and vulnerable groups, with the ultimate goal of transforming project outcomes into policies for the benefit of the entire population.
Emphasizing Injury Surveillance and Prioritizing Injury Prevention and Control
Effective injury prevention and control hinge on the fundamental collection of injury data, with injury surveillance being a pivotal method for this data collection. Since the inaugural World Conference on Injury Prevention and Control in 1989, global efforts have been concentrated on enhancing injury surveillance as a cornerstone of injury prevention and control. The main goal of injury surveillance is to delineate the specific disease burden of injuries, their epidemiological distribution, characteristics, and evolving trends (5-6). It seeks to address fundamental questions: “What is the problem?” and “Why does it occur?”. Additionally, injury surveillance is vital for assessing the efficacy of intervention strategies, shedding light on “What works?” and “How can it be implemented?”. An effective injury surveillance system should embody key attributes such as simplicity, flexibility, acceptability, reliability, usefulness, sustainability, and timeliness, while ensuring high levels of safety and confidentiality.
China has been proactively developing a comprehensive, national injury surveillance system (7-8). Initiated in 2008 by the National Center for Chronic and Noncommunicable Disease Control and Prevention (NCNCD) of the China CDC, this system is conceptualized on the injury pyramid theory. It combines the National Injury Surveillance System (NISS) with data from the existing National Disease Surveillance Points (DSP), medical records related to injuries, and periodic population-based epidemiological surveys. This integration offers a thorough national overview of injury incidents. Established in 2005, the NISS is the first specialized Chinese injury surveillance system, tracking injury cases in over 310 health facilities. The DSP System, operational since 1978 with 605 sites, monitors population mortality and disease patterns, providing health indicators like mortality rates and life expectancy. Over the past decade, NCNCD has furthered the use of this comprehensive system. For example, in 2013, a collaborative report on child road traffic injuries was released with the Ministry of Public Security. Epidemiological surveys on child injuries and elderly falls were conducted in 2016 and 2022, respectively. The China Injury Status Report 2019 was published in 2019. From 2023 onwards, population-based epidemiological injury surveys are part of the Population Health and Health Services Monitor and the National Health Services Survey. These advancements largely stem from the development and ongoing enhancement of the national injury surveillance system. Notably, Zhejiang and Guangdong Provinces have seen successful implementations of provincial-level comprehensive injury surveillance systems (9-10). Zhejiang Province, for instance, has developed a system that encompasses cause-of-death monitoring, hospital injury surveillance, and community surveys, significantly aiding local injury prevention and control initiatives. In Guangdong Province, product injury surveillance findings are leveraged for in-depth investigations into product quality, substantially aiding in the recall of defective products....
Language: en |