The burden of injury in Central, Eastern, and Western European sub-region: a systematic analysis from the Global Burden of Disease 2019 Study

Juanita A. Haagsma, Periklis Charalampous, Filippo Ariani, Anne Gallay, Kim Moesgaard Iburg, Evangelia Nena, Che Henry Ngwa, Alexander Rommel, Ausra Zelviene, Kedir Hussein Abegaz, Hanadi Al Hamad, Luciana Albano, Catalina Liliana Andrei, Tudorel Andrei, Ippazio Cosimo Antonazzo, Olatunde Aremu, Ashokan Arumugam, Alok Atreya, Avinash Aujayeb, Jose Luis Ayuso-MateosLuchuo Engelbert Bain, Maciej Banach, Till Winfried Bärnighausen, Francesco Barone-Adesi, Massimiliano Beghi, Derrick A. Bennett, Akshaya S. Bhagavathula, Félix Carvalho, Giulio Castelpietra, Ledda Caterina, Joht Singh Chandan, Rosa A.S. Couto, Natália Cruz-Martins, Giovanni Damiani, Anna Dastiridou, Andreas K. Demetriades, Diana Dias-da-Silva, Adeniyi Francis Fagbamigbe, Seyed Mohammad Fereshtehnejad, Eduarda Fernandes, Pietro Ferrara, Florian Fischer, Urbano Fra.Paleo, Silvia Ghirini, James C. Glasbey, Ionela Roxana Glavan, Nelson G.M. Gomes, Michal Grivna, Netanja I. Harlianto, Josep Maria Haro, M. Tasdik Hasan, Sorin Hostiuc, Ivo Iavicoli, Milena D. Ilic, Irena M. Ilic, Mihajlo Jakovljevic, Jost B. Jonas, Jacek Jerzy Jozwiak, Mikk Jürisson, Joonas H. Kauppila, Gbenga A. Kayode, Moien A.B. Khan, Adnan Kisa, Sezer Kisa, Ai Koyanagi, Manasi Kumar, Om P. Kurmi, Carlo La-Vecchia, Demetris Lamnisos, Savita Lasrado, Paolo Lauriola, Shai Linn, Joana A. Loureiro, Raimundas Lunevicius, Aurea Madureira-Carvalho, Enkeleint A. Mechili, Azeem Majeed, Ritesh G. Menezes, Alexios Fotios A. Mentis, Atte Meretoja, Tomislav Mestrovic, Tomasz Miazgowski, Bartosz Miazgowski, Andreea Mirica, Mariam Molokhia, Shafiu Mohammed, Lorenzo Monasta, Francesk Mulita, Mukhammad David Naimzada, Ionut Negoi, Subas Neupane, Bogdan Oancea, Hans Orru, Adrian Otoiu, Nikita Otstavnov, Stanislav S. Otstavnov, Alicia Padron-Monedero, Songhomitra Panda-Jonas, Shahina Pardhan, Jay Patel, Paolo Pedersini, Marina Pinheiro, Ivo Rakovac, Chythra R. Rao, Salman Rawaf, David Laith Rawaf, Violet Rodrigues, Luca Ronfani, Dominic Sagoe, Francesco Sanmarchi, Milena M. Santric-Milicevic, Brijesh Sathian, Aziz Sheikh, Rahman Shiri, Siddharudha Shivalli, Inga Dora Sigfusdottir, Rannveig Sigurvinsdottir, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Catalin Gabriel Smarandache, Bogdan Socea, Raúl A.R.C. Sousa, Paschalis Steiropoulos, Rafael Tabarés-Seisdedos, Marcos Roberto Tovani-Palone, Fimka Tozija, Sarah Van de Velde, Tommi Juhani Vasankari, Massimiliano Veroux, Francesco S. Violante, Vasiliy Vlassov, Yanzhong Wang, Ali Yadollahpour, Sanni Yaya, Mikhail Sergeevich Zastrozhin, Anasthasia Zastrozhina, Suzanne Polinder, Marek Majdan

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19 Citations (Scopus)

Abstract

Background: Injury remains a major concern to public health in the European region. Previous iterations of the Global Burden of Disease (GBD) study showed wide variation in injury death and disability adjusted life year (DALY) rates across Europe, indicating injury inequality gaps between sub-regions and countries. The objectives of this study were to: 1) compare GBD 2019 estimates on injury mortality and DALYs across European sub-regions and countries by cause-of-injury category and sex; 2) examine changes in injury DALY rates over a 20 year-period by cause-of-injury category, sub-region and country; and 3) assess inequalities in injury mortality and DALY rates across the countries. Methods: We performed a secondary database descriptive study using the GBD 2019 results on injuries in 44 European countries from 2000 to 2019. Inequality in DALY rates between these countries was assessed by calculating the DALY rate ratio between the highest-ranking country and lowest-ranking country in each year. Results: In 2019, in Eastern Europe 80 [95% uncertainty interval (UI): 71 to 89] people per 100,000 died from injuries; twice as high compared to Central Europe (38 injury deaths per 100,000; 95% UI 34 to 42) and three times as high compared to Western Europe (27 injury deaths per 100,000; 95%UI 25 to 28). The injury DALY rates showed less pronounced differences between Eastern (5129 DALYs per 100,000; 95% UI: 4547 to 5864), Central (2940 DALYs per 100,000; 95% UI: 2452 to 3546) and Western Europe (1782 DALYs per 100,000; 95% UI: 1523 to 2115). Injury DALY rate was lowest in Italy (1489 DALYs per 100,000) and highest in Ukraine (5553 DALYs per 100,000). The difference in injury DALY rates by country was larger for males compared to females. The DALY rate ratio was highest in 2005, with DALY rate in the lowest-ranking country (Russian Federation) 6.0 times higher compared to the highest-ranking country (Malta). After 2005, the DALY rate ratio between the lowest- and the highest-ranking country gradually decreased to 3.7 in 2019. Conclusions: Injury mortality and DALY rates were highest in Eastern Europe and lowest in Western Europe, although differences in injury DALY rates declined rapidly, particularly in the past decade. The injury DALY rate ratio of highest- and lowest-ranking country declined from 2005 onwards, indicating declining inequalities in injuries between European countries.

Original languageEnglish
Article number142
JournalArchives of Public Health
Volume80
Issue number1
DOIs
Publication statusPublished - Dec 2022
Externally publishedYes

Keywords

  • Burden of disease
  • Disability adjusted life years
  • Europe
  • Injuries
  • Mortality

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