Page 9 - Big Book of Accident Prevention

Mortality and Preventable 9 Years of Life Lost (PrYLL) Death rates and years of life lost due to accidents A fresh look at the evidence The consequences of this new approach are even more significant when we also include young children and look at the 0–60 age group – Fig 5. Human life is precious and we have a moral obligation to challenge the leading causes of death. Doesn’t it make sense to invest limited public funds into areas where we can save the most lives, especially if that coincides with Figure 5 – % of total preventable years of life lost (PrYLL) in 2010 to people up to age 60 making the most savings to the NHS? Our fresh look at the evidence has led to a radical reappraisal of the investment priorities for public health. The 30% traditional starting point in public health is to focus on mortality data – Fig 4. 25% Unintentional injuries 23% 20% Figure 4 – % of all deaths in 2010 by all underlying cause, all ages 30% 15% Unintentional injuries 2% 25% % of total years of life lost 10% % of all Deaths 20% 5% 0% 15% Preventable Cancer Ischaemic Heart Disease Other cardiovascular diseases 10% Unintentional injuries Suicide Alcohol-related Homicide/assault & misadventures Infections Illicit drug use Respiratory diseases Diabetes 5% Source: RoSPA/Office for National Statistics for England & Wales At 23% of all PrYLL to people aged 0–60, unintentional injuries are the leading cause of preventable, premature mortality. This continues to be the case into people’s 70s, making accidents the dominant cause of preventable 0% Cancers *Others Infections death in our lives. In the mid-80s (beyond life expectancy), accidents then fall behind preventable cancers and heart IHD ( Ischaemic Heart Disease) Cardiovascular diseases excl. IHD Respiratory diseases Unintentional injuries Diabetes mellitus Homicide/assault & misadventures disease to become the third most significant cause of preventable mortality. Intentional self-harm Alcohol-related disease Illicit drug use disorders But this is not the whole story. There are other factors which we want to measure precisely but which indicate that the case for accident prevention is even stronger: Underlying causes of death Source: RoSPA / Office for National Statistics for England & Wales • Quality Adjusted Life Years (QALYs). If these were measured too, the position of accidents on this scale * Others includes mental disorders and diseases of the nervous, digestive and genito-urinary systems would become even more significant, since they affect the young so much. • Morbidity/mortality ratios. For every life saved through an accident prevention programme, many more According to ONS data for England and Wales, the leading causes of death in 2010 were cancers, serious and minor injuries can be prevented, a factor which does not apply to diseases in the same way. cardiovascular diseases and respiratory diseases. At just 2% of total deaths, unintentional injuries may appear to be a relatively small problem and therefore a relatively low priority for public health. • Efficacy. Accident prevention is already known to be one of the cheapest and most effective forms of public health intervention. • Changing priorities. Heart disease rates are dropping, cancer rates are stable but accident rates are However, this changes significantly when we consider the value of all of the years of life lost (YLL) increasing. If we don’t react soon, accidental death and injury will become even more of an issue. as the result of premature death using ONS data. This brings accidents rapidly up the priority list, accounting, in this example, for 11% of all YLL to the working population (15–64). Unintentional injuries 11% Taking all of these factors into account, it is clear that accident prevention should be the No. 1 priority for public health in this country. Aligning the dominant cause of premature, preventable death (measured in PrYLL) with Finally, we have looked at YLL due to preventable causes of death in the working population, the most cost-effective intervention strategies presents us with a superb opportunity to save lives and reduce filtering out those which we just can’t prevent. Accidents now account for 19%. During this injuries on a hitherto unprecedented scale. three-stage process, unintentional injuries have moved from being a relatively minor issue to becoming a leading priority for public health. Unintentional injuries 19% The Royal Society for the Prevention of Accidents