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The Barcelona Injury Surveillance System (BISS) for Safer Cities: Observational, Descriptive Study Using Routine
Katherine Pérez1,2,3, Elena Santamariña-Rubio1, Mònica Cortés-Albaladejo1,3
1Agència de Salut Pública de Barcelona (ASPB), Pl Lesseps, 1, Barcelona, 08023, Spain, 34 932027788.
JMIR Public Health and Surveillance
|July 24, 2026
Summary
The Barcelona Injury Surveillance System (BISS) integrates health and police data to monitor urban injuries. It reveals key prevention priorities, including falls in older women and self-harm in young females, while highlighting higher mortality rates in males.
Area of Science:
- Public Health
- Epidemiology
- Urban Health Surveillance
Background:
- Cities often lack comprehensive injury surveillance systems to monitor injury burden across diverse populations and mechanisms.
- Spain lacked a city-level system capturing the full spectrum of injuries.
- The Barcelona Injury Surveillance System (BISS) was developed to address this gap by integrating routine health and police data.
Purpose of the Study:
- To describe the Barcelona Injury Surveillance System (BISS), including its scope, data sources, and public health rationale.
- To illustrate the utility of BISS through the analysis of recent injury data in Barcelona.
Main Methods:
- A descriptive study utilizing routinely collected emergency department, hospital discharge, mortality, and police data integrated into BISS.
- Analysis of nonfatal injuries in 2024, fatal injuries in 2023, and trends from 2018 onward.
- Examination of injury indicators by sex, age, mechanism, type, and severity, calculating crude and age-adjusted rates per 100,000 residents.
Main Results:
- In 2024, BISS recorded 123,420 emergency department injury episodes and 18,749 hospitalizations.
- In 2023, 695 injury-related deaths were recorded among residents.
- Falls were the leading mechanism, concentrated in older females; self-harm rates were highest in young females, while mortality rates were higher in males. Nonfatal injuries increased from 2018-2024, with a decline in road traffic injuries.
Conclusions:
- The Barcelona Injury Surveillance System (BISS) demonstrates the value of integrating routine health and police data for actionable urban injury intelligence.
- Findings highlight prevention priorities: falls in older females, self-harm in young females, and higher fatal injury burden in males.
- Integrated city-level surveillance systems like BISS support monitoring, equity-oriented prevention, and data-informed public health policy.
