Safety 2016Future Challenges and Solutions for Safety in
ChinaDr. Leilei DuanDirector, Division of Injury PreventionNational Center for Chronic and Noncommunicable Disease Control and Prevention, China CDC2016. 9 Finland
Situation
01
Challenge
Solution
02
Situation Challenge
Solution
Source: Data Sets of Death Surveillance of China , 2014Leading cause of Death by Age Groups in China, 2014 0
3
Rank <1 yr 1-4 yrs 5-14 yrs 15-29 yrs 30-44 yrs 45-64 yrs ≥65 yrs All ages
1 Birth trauma and choking Drowning Drowning Road traffic
injuriesRoad traffic injuries
Cerebrovascular disease
Cerebrovascular disease
Cerebrovascular disease
2 Low birth weight Road traffic injuries
Road traffic injuries
Self-inflicted injuries
Cerebrovascular disease
Ischaemic heart disease
Ischaemic heart disease
Ischaemic heart disease
3 Congenital heart anomalies
Lower respiratory infections
Leukaemia Drowning Ischaemic heart disease Lung cancer
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease
4 Lower respiratory infections
Congenital heart anomalies
Congenital heart anomalies Falls Liver cancer Liver cancer Lung cancer Lung cancer
5 Road traffic injuries Falls Falls Leukaemia Lung cancer Road traffic
injuriesHypertensive heart disease Liver cancer
6 Meningitis LeukaemiaLower respiratory infections
Cerebrovascular disease
Self-inflicted injuries Stomach cancer Stomach cancer Hypertensive
heart disease
7 Anorectal atresia Poisonings Poisonings Ischaemic heart disease Falls
Chronic obstructive pulmonary disease
Liver cancer Stomach cancer
8 Falls Epilepsy Self-inflicted injuries Poisonings Poisonings Esophagus canc
erLower respiratory infections
Road traffic injuries
9 Down's syndrome Fires Endocrine disorder Liver cancer Stomach cancer Diabetes Diabetes Esophagus cancer
10 Diarrhea Meningitis Meningitis Congenital heart anomalies Liver cirrhosis Hypertensive
heart diseaseEsophagus cancer Diabetes
11 Drowning Inflammatory heart disease Epilepsy Nephritis and
nephropathyNephritis and nephropathy
Colon and rectum cancers
Colon and rectum cancers
Lower respiratory infections
12 Protein-energy malnutrition
Lymphomas and multiple myeloma
Lymphomas and multiple myeloma
Interpersonal violence Breast cancer Self-inflicted
injuries Falls Colon and rectum cancers
13 Leukaemia Protein-energy malnutrition
Nephritis and nephropathy Epilepsy Leukaemia Liver cirrhosis
Alzheimer's disease and other dementia
Falls
14 Inflammatory heart disease
Interpersonal violence
Cerebrovascular disease Lung cancer Colon and
rectum cancers Falls Nephritis and nephropathy
Self-inflicted injuries
15 Esophageal atresia
Nephritis and nephropathy
Interpersonal violence
Lower respiratory infections
Drowning Breast cancer Road traffic injuries
Nephritis and nephropathy
16 Cleft Palate Diarrhea Inflammatory heart disease
Lymphomas and multiple myeloma
Hepatitis B Nephritis and nephropathy
Self-inflicted injuries Liver cirrhosis
17 Poisonings Iron drficiency Fires Tuberculosis Diabetes Pancreatic cancer
Rheumatic heart disease
Alzheimer's disease and other dementia
18 Epilepsy Down's syndrome Diabetes Endocrine disor
der Cervical cancer Hepatitis B Pancreatic cancer Pancreatic cancer
19 Nephritis and nephropathy
Upper respiratory infection
Tuberculosis Stomach cancer Hypertensive heart disease Cervical cancer Liver cirrhosis Rheumatic heart
disease
20 Abdominal-wall defect
Birth trauma and choking
Chronic obstructive pulmonary disease
Colon and rectum cancers
Chronic obstructive pulmonary disease
Lip, oral cavity and pharynx cancer
Peptic ulcer Drowning
Source: Global Burden of Disease 2013
SITUATION — Fatal injuries
Death rate for male in 2013
75.5604
1987 1992 1997 2002 2007 2012 0
20
40
60
80
100
120
140
92
57
73
37
111
76
Male Female Total
1990 1995 2000 2005 2010 2013
Death rate in 201356.69
Death rate for female in 2013
36.73Trend of injury death rate by gender in China from 1990 to 2013
Road traffic injuriesSelf-harmFallsDrowningExposure to mechanical forcesPoisoningsInterpersonal violenceOthers
Source: Global Burden of Disease 2013
Road traffic injuries37%
Self-harm 16%
Drowning9%
05
Falls15%
Others10%
SITUATION — Fatal injuries
Distribution of injury deaths by cause in China, 2013
Source: China injury prevention report; Gao Maolong et al. The meta analysis of elderly falls in China.
Injuries in students
35% - 50%
06
Injuries in community
16% - 22%Falls in elderlys
6% - 21%
Incidence of injuriesfrom different studies in China
Incidence
SITUATION — Nonfatal injuries
FallsRoad traffic injuriesBlunt injuriesKnife/Sharp injuriesAnimal injuriesIntentional injuriesBurnPoisoningsSuicideSuffocation/HangingFirearmDrowningUnknownOthers
Source: National Injury Surveillance System (NISS), 2015
Falls37%
Road traffic injuries16%
Knife/Sharp injuries9%
07
Blunt injuries11%
SITUATION — Nonfatal injuries
Animal injuries16%
Distribution of injury cases by cause from National Injury Surveillance System in China, 2015
Sorce: WANG Hao-chen et al. Chinese Injury Caused Disability Paradigm Shift: Based on National Sampling Surveys on Disability 2014
SITUATION — Disabilities 08
Proportion of disability caused by injuries in
China
9%
Injury disability
1987
Proportion of disability caused by injuries in
China
Injury disability
16%2006
Source: Global Burden of Disease 2013
SITUATION — GBD 09
1987 1992 1997 2002 2007 20120.00
1000.00
2000.00
3000.00
4000.00
5000.00
6000.00
7000.00
5082.01
2579.65
3938.17
1562.81
6151.51
3527.79
Male Female Total
1990 1995 2000 2005 2010 2013
Trend of DALYs rate of injuries by gender in China from 1990 to 2013
Age-standardized DALYs rate of injuries by province in China, 2013
Source: : Data Sets of Death Surveillance of China ,2014/Global Burden of Disease 2013
SITUATION
The burden of injury decreased from 1990 to 2013Injury burden0
1 Injury is the leading death cause of population aged 1-44
Injury02 Road traffic injury is the leading death
cause of injury of all-age populationRoad traffic injury0
3 Drowning is the leading death cause of injury in the children aged 1-17
Drowning04 Falls is the leading death cause of injury
in the elderly aged 70 and aboveFalls0
5
10
Situation
11
Challenge
Solution
Injury
Urban self-harm
Child injury
NeglectOccupational injury
……
2000 20130%
10%20%30%40%50%60%
36%
54%
Percentage of urban people
Source: China Statistical Yearbook, 2015.
CHALLENGE — Urbanization 12
2000 20100%
5%
10%
15%
20%
25%
8.05%
21.88%
Percentage of rural
left-behind children
1990 20050
20 40 60 80
100 120 140 160 180
80
161
Number of
couples of divorce
(100,000)
2008 20150
5,000
10,000
15,000
20,000
25,000
30,000 22542
27747
Number of
migrant workers
(100,000)
Road0
70
140
210
280
350
420
490
Vehicles Drivers0
5000
10000
15000
20000
25000
30000
35000
Road traffi
c injur
y
Source: Statistic annual report on road traffic accident 2014, Traffic management bureau of Ministry of Public Security
CHALLENGE — Motorization 13
Vehicles Drivers0
5000
10000
15000
20000
25000
30000
35000
Road0
70
140
210
280
350
420
490
Number of vehicles (10 000) Length of roads (10 000 )
Number of drivers (10 000)
2000 2014
Source: National Bureau of Statistics of the People’s Republic of China
CHALLENGE — Aging
19951996
19971998
19992000
20012002
20032004
20052006
20072008
20092010
20112012
20132014
20150%
2%
4%
6%
8%
10%
12%
Trend of percentage of the elderly aged 65+ in China from 1995 to 2015
Elderly Injury
Falls
Road traffic injury
Self-harmAbuse
……4.3%
14
CHALLENGE——Unbalance
Need Supply
Policy
Finance
Human resource
Injury
Burden
Need Supply
15
CHALLENGE
Culture
Social norms
Behavior ……
16
Situation
17
Challenge
Solution
Evidence Model Support Team Cooperation
Evidence Model Support Team CooperationEvidence Model Support Team CooperationEvidence Model Support Team CooperationEvidence Model Support Team CooperationEvidence Model Support Team CooperationEvidence Model Support Team Cooperation
SurveillanceSurveyEvaluationResearch
Evidence-based
Issue-oriented
Target population focused
Multi-sectoral cooperation and Win-win
Entire Society Participation
Policy consultation
Technical assistance
NHFPC
Local CDC
Other Government departmentsWorking
guidelines and toolsPolicy
consultationTechnical assistance
Working guidelines and
tools
Nationwide capacity building workshops and seminars
Person-times CDC staff were trained
Certifications of National Continuing Education Credits
191500
900
SOLUTIONWe did …We work together …We promise.
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SOLUTIONWe promise.
GGoverGovernmeGovernmentProfessional organProfessioProfessional organizations
Public
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SAVING LIVESThanks!Dr. Leilei DuanEmail: [email protected]