Zhao Zhongtang, Svanström Leif
Department of Epidemiology and Bio-statistics, School of Public Health, Shandong University, Jinan, Shandong, China.
Health Promot Int. 2003 Sep;18(3):247-53. doi: 10.1093/heapro/dag020.
The objective of this paper is to introduce the epidemiology of injuries in China, and then consider the development of safe communities in regard to injury prevention and safety promotion. The disease spectrum has changed in recent decades in the People's Republic of China. Both in cities and rural areas, injury has become the fifth leading cause of death. At least 800 000 people die from injury each year, and 50 million non-fatal injuries occur, of which 2.3 million lead to disability of varying degrees of severity. The average injury-related death rate in China from 1990 to 1997 was 66 per 100 000, which accounts for 11% of total deaths. The potential years of life lost (PYLL) of injury accounts for 24% of the total, and disability-adjusted life years (DALYs) account for 17%. Main injury causes of death, in descending order, are: suicide, traffic accident, drowning, falling, poisoning, homicide, burn and scald, and iatrogenic injury. Considering China's current injury status and its rapid societal change, injury prevention and safety promotion need to be strengthened further, and there is a special need for the development of Safe Communities programmes. The prevention of injuries through safety promotion has been increasingly focussed on over recent decades. The WHO Safe Community model is recognized as representing an effective and long-term approach to the prevention of injuries at a local level, and has been beneficially applied all over the world. A programme may cover several aspects of injury prevention and safety promotion simultaneously, or only include one or two aspects. In a Safe Community programme in China, children, the elderly, cyclists and their passengers, and farmers should be among the prioritized target populations. However, multi-focussed inter-sectoral programmes have been shown to have additional effects to distinct sectoral programmes.
本文的目的是介绍中国伤害的流行病学情况，进而探讨在伤害预防和安全促进方面安全社区的发展。近几十年来，中华人民共和国的疾病谱发生了变化。在城市和农村地区，伤害已成为第五大死因。每年至少有80万人死于伤害，发生5000万起非致命伤害，其中230万起导致不同程度的残疾。1990年至1997年中国与伤害相关的平均死亡率为每10万人66例，占总死亡人数的11%。伤害导致的潜在寿命损失年（PYLL）占总数的24%，伤残调整生命年（DALY）占17%。主要的伤害死因按降序排列为：自杀、交通事故、溺水、跌倒、中毒、他杀、烧伤和烫伤以及医源性伤害。考虑到中国目前的伤害状况及其快速的社会变革，伤害预防和安全促进需要进一步加强，特别需要发展安全社区项目。近几十年来，通过安全促进预防伤害越来越受到关注。世界卫生组织的安全社区模式被认为是在地方层面预防伤害的一种有效且长期的方法，并已在全球得到有益应用。一个项目可能同时涵盖伤害预防和安全促进的几个方面，或者只包括一两个方面。在中国的一个安全社区项目中，儿童、老年人、骑自行车的人及其乘客以及农民应是优先目标人群。然而，多重点跨部门项目已被证明比单独的部门项目有额外的效果。
