Mortality from injuries

Injuries are a leading cause of death and disability for all age groups and took 2.3 million lives in 2016 in WPRO and SEARO, accounting for 8.6% of all deaths in these regions. Injuries can result from traffic collisions, drowning, poisoning, falls or burns, and violence from assault, self-inflicted or acts or war. The magnitude of the problem varies considerably across countries and territories by cause, age, sex, and income group. However, injury deaths, both intentional and unintentional, are largely preventable events.

Mortality from injuries was highest in India, Myanmar, Cambodia and Thailand with greater than 70 deaths per 100 000 populations, while the rate was lowest in Hong Kong, China; and Singapore with 15 deaths per 100 000 population in 2016 (Figure 3.19). Lower-middle and low income Asia-Pacific countries and territories had twice the injury mortality rate than OECD countries (64 versus 31 deaths per 100 000 population).

Injury deaths have declined in all Asia-Pacific countries and territories between 2000 and 2016. A large decrease in injury deaths observed in Sri Lanka was due to the end of armed conflict in 2009.

Deaths due to road traffic crashes represent 37.7% and 30.1% of all injuries deaths in upper-middle and lower-middle and low income Asia-Pacific countries and territories respectively in 2016. However, this figure should be considered in the context of a corresponding global increase in the number of registered vehicles, suggesting that interventions to improve global road safety have mitigated the expected rise in the number of deaths (WHO, 2018[20]). With the support of Bloomberg Philanthropies, the WHO, the Global Road Safety Partnership and Johns Hopkins University have been implementing the Bloomberg Philanthropies Global Road Safety Programme (BP-GRSP) in ten countries and territories with high burden of fatal road traffic injuries, including China, Cambodia, India, and Viet Nam. Commencing in 2010, this five-year programme focuses on saving lives and preventing injuries by scaling up enhanced enforcement of major risk factors like motorcycle helmet wearing, speed, alcohol or seatbelts, pertinent to each country (Peden, 2010[21]). On 11 May 2011, the first ever Decade of Action for Road Safety 2011-20 was launched with great enthusiasm and optimism across the world. Mandated by the United Nations General Assembly, the Decade is a historic opportunity for countries and territories to stop and reverse the trend which – without action – would lead to the loss of around 1.9 million lives on the roads each year by 2020 (http://www.who.int/roadsafety/decade_of_action/en/). This policy message was strengthen by SDG 3.6, which targets halving the number of global deaths and injuries from road traffic accidents by 2020.

The main causes of injury deaths are different across countries and territories in the region (Figure 3.20). In China, Solomon Islands, Thailand and Malaysia, 39% or more of all injury deaths were due to road traffic crashes, while in the Republic of Korea mortality rates for road traffic injuries are one of the highest in high-income countries and territories at 19.9% of all injury deaths. In the Republic of Korea, Singapore and Japan, self-inflicted injuries were the leading cause of injury mortality, accounting for over 50% of all injury deaths. Over 90% of people who had attempted or committed suicide were diagnosed with psychiatric disorders such as severe depression, bipolar disorder and schizophrenia (Turecki and Brent, 2016[22]), but mental disorders are still under-treated or ineffectively treated (Hewlett and Moran, 2014[23]). Interpersonal violence is the main cause of injury deaths for men in the Philippines.

Age-specific mortality was consistently higher in middle and low-income countries and territories across all age groups, and significant higher for children up to the age of 15 (Figure 3.21). Drowning is the leading cause of unintentional injury-related deaths among those aged 5-14 in the region (WHO, 2104[24]). Drowning is a largely preventable cause of death that is strongly associated with poverty. Population most at risk are those living in low-income countries and territories of densely populated communities with high exposure to open water.

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