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低收入和中等收入国家道路交通伤害的公平维度

Equity dimensions of road traffic injuries in low- and middle-income countries.

作者信息

Nantulya Vinand M, Reich Michael R

机构信息

Harvard Center for Population and Development Studies, Cambridge, MA 02138, USA.

出版信息

Inj Control Saf Promot. 2003 Mar-Jun;10(1-2):13-20. doi: 10.1076/icsp.10.1.13.14116.

Abstract

Globally, poorer population groups bear a disproportionate burden of avoidable morbidity and mortality from road traffic injuries. The distribution of road traffic injuries is generally influenced by socioeconomic factors. Poor countries bear a disproportionate burden of injuries and fatalities, and within countries, poor people account for a disproportionate portion of the ill health due to road traffic injuries. The main source of data for this paper was the road traffic injury database of the WHO World Health Report for 1999 supplemented by the WHO Global Burden of Disease Study 2000 report, and published and unpublished works. Fatality rates for 0-4 and 5-14 year olds in low- and middle-income regions, measured as deaths per 100,000 population, were six times the rates for high-income regions, while within low- and middle-income regions the rates varied widely. Within poor countries, poor people--represented by pedestrians, passengers in buses and trucks, and cyclists--suffer a higher burden of morbidity and mortality from traffic injuries. In rich countries, children from poor socioeconomic classes suffer more injuries and deaths from road crashes than their counterparts from high-income groups. The disproportionate burden of morbidity and mortality in low- and middle-income countries, and among low socioeconomic groups in those countries, illustrates problems of global inequities in health. The problems can be addressed through policies that focus on the road safety of vulnerable groups.

摘要

在全球范围内,较贫困人群承受着道路交通伤害导致的可避免发病和死亡的不成比例的负担。道路交通伤害的分布通常受社会经济因素影响。贫穷国家承受着不成比例的伤害和死亡负担,而且在各国国内,贫困人口因道路交通伤害导致的健康不佳所占比例也不成比例。本文的数据主要来源是1999年世卫组织《世界卫生报告》的道路交通伤害数据库,并辅以2000年世卫组织《全球疾病负担研究》报告以及已发表和未发表的著作。低收入和中等收入地区0至4岁和5至14岁儿童的死亡率(以每10万人口中的死亡人数衡量)是高收入地区的六倍,而在低收入和中等收入地区内,死亡率差异很大。在贫穷国家,以行人、公共汽车和卡车乘客以及骑自行车者为代表的贫困人口承受着更高的交通伤害发病和死亡负担。在富裕国家,社会经济阶层较低的儿童比高收入群体的儿童在道路撞车事故中遭受更多伤害和死亡。低收入和中等收入国家以及这些国家中社会经济地位较低群体中不成比例的发病和死亡负担,说明了全球卫生不平等问题。这些问题可以通过关注弱势群体道路安全的政策来解决。

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