article · Injury Prevention
Injuries remain a major cause of health loss across the world. An evaluation of global injury data between 1990 and 2017 demonstrates shifts in both fatal and non-fatal injury patterns. Worldwide injury deaths rose from roughly 4.26 million in 1990 to 4.48 million in 2017, although age-standardised mortality rates fell considerably from 1079 to 738 per 100,000. Over the same span, annual new cases of injury expanded substantially from 354 million to over 520 million, whilst age-standardised incidence rates experienced only a minor, non-significant change. Overall health loss, measured in age-standardised disability-adjusted life years, dropped from 4947 to 3267 per 100,000. These long-term trends highlight that despite improvements in survival and lower overall burden rates, the total volume of non-fatal injuries and deaths continues to climb globally.
Tracking global injury trends helps health systems recognise where safety measures and medical interventions are succeeding and where gaps remain. While overall death rates adjusted for age are falling, the absolute number of people sustaining injuries is expanding rapidly, driving up global demands on emergency healthcare services, trauma centres, and long-term rehabilitation systems.
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BACKGROUND: Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. METHODS: We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). FINDINGS: In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). INTERPRETATION: Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.
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DOI: 10.1136/injuryprev-2019-043494
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