Department of Public Health Sciences, Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18 A, 171 77 Stockholm, Sweden.
Department of International Health, Maastricht University, Universiteitssingel 40, 6229 ET Maastricht, The Netherlands.
Int J Environ Res Public Health. 2019 Feb 22;16(4):653. doi: 10.3390/ijerph16040653.
Decreases in injury rates globally and in Europe in the past decades, although encouraging, may mask previously reported social inequalities between and within countries that persist or even increase. European research on this issue has not been systematically reviewed, which is the aim of this article. Between and within-country studies from the WHO European Region that investigate changes in social inequalities in injuries over time or in recent decades were sought in PubMed, Scopus, and Web of Science. Of the 27 studies retained, seven were cross-country and 20 were country-specific. Twelve reported changes in inequalities over time and the remaining 15 shed light on other aspects of inequalities. A substantial downward trend in injuries is reported for all causes and cause-specific ones-alongside persisting inequalities between countries and, in a majority of studies, within countries. Studies investigate diverse questions in different population groups. Depending on the social measure and injury outcome considered, many report inequalities in injuries albeit to a varying degree. Despite the downward trends in risk levels, relative social inequalities in injuries remain a persisting public health issue in the European Region.
尽管过去几十年全球和欧洲的伤害率有所下降令人鼓舞，但这可能掩盖了此前报告的国家间和国家内持续存在甚至加剧的社会不平等现象。欧洲在这一问题上的研究尚未进行系统审查，本文旨在对此进行综述。在 PubMed、Scopus 和 Web of Science 中检索了世界卫生组织欧洲区域内研究随时间或近几十年来伤害社会不平等变化的国家间和国家内研究。保留的 27 项研究中，有 7 项为跨国研究，20 项为特定国家的研究。其中 12 项报告了不平等现象随时间的变化，其余 15 项则揭示了不平等现象的其他方面。报告显示，所有原因和特定原因的伤害都呈大幅下降趋势，同时国家间持续存在不平等现象，在大多数研究中，国家内也存在不平等现象。研究在不同人群中调查了不同的问题。根据所考虑的社会指标和伤害结果，许多研究报告了伤害方面的不平等，尽管程度不同。尽管风险水平呈下降趋势，但伤害方面的相对社会不平等仍然是欧洲区域内一个持续存在的公共卫生问题。
