Inequalities in injury burden in the Americas, 2000-2021: A systematic analysis

To assess mortality and disability due to injuries in the Americas, with a focus on subregional and gender disparities, and changes over time.

Data from the 2021 World Health Organization Global Health Estimates were analyzed, covering all injury causes (ICD-10: V01-Y89) across 35 countries in the Americas from 2000 to 2021. Age-standardized mortality and disability-adjusted life year (DALY) rates were calculated by sex, cause, and subregion. Inequalities were quantified using absolute differences, relative ratios, and the index of disparity (IDisp).

In 2021, injuries caused over 662 000 deaths and 40.6 million DALYs in the Americas, with men accounting for nearly three-quarters of the burden. While age-standardized injury rates declined in most subregions, marked inequalities persisted. Interpersonal violence was the leading cause of injury-related mortality and disability, followed by road injuries, especially among men and boys aged 15-39 years. Self-harm increased substantially in both sexes, and falls rose in association with population aging. Interpersonal violence and drowning showed the highest between-country disparities, with IDisp values of 85.3 and 88.9, respectively, in 2021.

Although some progress has been made in reducing injury burden in parts of the Americas, substantial challenges, including in some cases widening inequalities, remain. A renewed commitment to violence and injury prevention - rooted in equity, intersectoral action, and regional collaboration - is essential to reducing avoidable harms across the life course.