Descriptive epidemiology of injury in the south east: identifying priorities for action

To demonstrate the significance of injury in relation to other health problems, to describe the pattern of injury in one region of England, and to identify priorities for further epidemiological and prevention work.

Cases were identified retrospectively from secondary data sources, namely using routinely collected data on deaths (OPCS anonymized death registrations for the period 1988-1991) and hospital in-patients (South Thames (East) RHA files of in-patient episodes). Denominator data for rates were obtained from the 1991 mid-year population estimates from the OPCS.

The cohort was defined as those resident in South Thames (East) during the study period, namely Kent, East Sussex, and South East London. The study period was 1988-1991 calendar years inclusive for the fatalities: and was the financial year from 1 April 1991-31 March 1992 for injury resulting in hospital admission.

Injuries were found to be the fifth leading cause of death, the third leading cause of potential years of life lost (PYLL), and the third most common cause of hospital bed utilisation. Injury rates varied dramatically with age, and sex. The highest injury death and hospitalization rates were amongst elderly people. The leading causes of injury death were motor vehicle traffic crashes (25%), and suicide (23%), and falls (15%); for injury hospitalizations they were falls (60% of bed-days), and motor-vehicle traffic crashes (13% of bed-days). The most common places identified for the occurrence of injury death were road, home and residential institutions. Those injuries that accounted for most admissions to hospital were fractures (59% of bed-days).

A number of areas have been identified as regional priorities. These are motor vehicle traffic crashes involving pedestrians (especially children under 15 and those aged 65 and over), car occupants and motor cyclists (especially young adult males); falls (especially those aged 65 and over); those occurring in residential institutions (especially for elderly people); fire and flames (affecting children under 15); suicide/self harm (all ages 15 and above); and homicide/assault (in males aged 15-34).