WHO:Be mobile, active - and safe!

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This text is taken from the WHO report "Health and Environment in Europe: Progress Assessment", 2010, ISBN 978 92 890 4198 0. [1]

Regional priority goal II: We aim to prevent and substantially reduce health consequences from accidents and injuries and pursue a decrease in morbidity from lack of adequate physical activity, by promoting safe, secure and supportive human settlements for all children.[1]

Key messages

  • Unintentional injuries are a leading cause of death in young people aged 0–19 years, with road traffic injuries contributing the largest burden followed by injuries occurring in the home and leisure settings. Inequalities between countries are extreme. A substantial reduction in traffic-related deaths over the last two decades shows that these injuries and deaths are preventable.
  • There is wide variability in the national proportions of overweight and obese children, ranging from 3% to more than 30% in 11–15-year-olds. The problem appears to be worsening in many countries in recent years.
  • Asubstantial proportion (often 40–50% or more) of 11-year-olds in all countries in the Region do not engage in enough physical activity; the proportion is even higher among 13-and 15-year-olds.
  • There is growing evidence that well-designed built environments and public green spaces enhance physical activity patterns and reduce the risk of injuries.
  • Coordinated, intersectoral injury prevention and health promotion policies are required to reduce health burdens from unintentional injuries, low physical activity levels and obesity.
  • Tailored approaches are required for specific groups of citizens to benefit from the full potential of public places and networks to exercise and be physically active, and to be protected from safety threats in the urban, transport, home and leisure environments.

Injuries and physical inactivity: public health importance

Unintentional injuries

Unintentional injuries cause 42 000 deaths in children and adolescents aged 0–19 years in the Region each year. Road traffic injuries are the leading cause of death, while deaths from drowning, poisoning, falls and fires are also substantial.

Boys suffer three out of four deaths from unintentional injuries in the Region, reflecting differences in exposure patterns compared to girls, particularly in relation to road traffic injuries. Five out of six of all deaths from unintentional injuries occur in poorer countries. Reducing child mortality rates from unintentional injuries across the Region to the lowest national rates would prevent around three out of four deaths.

The relative importance of the causes of injury changes as a child grows through adolescence to young adulthood owing to factors including curiosity, risk behaviour and awareness, coping skills, ability to follow instructions, mobility and the extent of supervision.

Deaths from unintentional injuries by cause, 0-19 years, WHO European Region, 2004 [1]
Top three causes of death (total deaths) due to unintentional injury in groups aged 0–4, 5–14 and 15–29 years, WHO European Region[1]

Road traffic injuries – a leading cause of death

Overall, road traffic injuries are the third leading cause of death in the Region among young people aged 0–24 years, which includes young and inexperienced drivers, causing about 100 deaths daily in this age group. Approximately four fifths of these deaths occur in the group aged 15–24 years, making them a major public health challenge for adolescents and young adults.

Deaths from road traffic injuries are not evenly distributed. Geographically, the highest rates occur in the north-eastern and eastern parts of the Region. Among EU member states, those in the north have lower mortality than those in the south. It is notable that countries with the highest death rates (Kazakhstan, Lithuania and the Russian Federation) have rates seven to eight times higher than those with the lowest rates. Deaths, however, are only the tip of the iceberg; on average, there are 35 injuries for each fatality, the consequences of which persist for many years. Furthermore, evidence shows that up to 33% of children involved in road traffic injuries develop post-traumatic stress disorder.

Death and injury rates from road traffic injuries depend on both driving-related factors, such as the number of vehicles, driving style and risk perception, the existence of legislation and the strength of its enforcement, road design and maintenance, and factors unrelated to driving, including emergency response services, mobility options and socioeconomic conditions. The overall death rates need, therefore, to be considered within this wider context. When this is done, it strongly modifies the ranking of countries. Kyrgyzstan, for example, reports the second lowest injury rate from road traffic injuries per 100 000 population but the highest injury rate per 100 000 motor vehicles (Fig. 16). Furthermore, for many countries the data on death and injury rates do not correlate: the Russian Federation, which has the highest death rate related to road traffic injuries in young people in the Region reports a relatively modest road traffic injury rate in the same group. Variations in reporting patterns, differences in definitions, and inconsistencies are likely to contribute to at least some of the discrepancies that exist between as well as within national data.
  1. 1.0 1.1 1.2 WHO Health and Environment in Europe: Progress Assessment, 2010, ISBN 978 92 890 4198 0[2]