leilei duan: future challenges and solutions for safety in china

Safety 2016Future Challenges and Solutions for Safety in

ChinaDr. Leilei DuanDirector, Division of Injury PreventionNational Center for Chronic and Noncommunicable Disease Control and Prevention, China CDC2016. 9 Finland

Situation

01

Challenge

Solution

02

Situation Challenge

Solution

Source: Data Sets of Death Surveillance of China , 2014Leading cause of Death by Age Groups in China, 2014 0

3

Rank <1 yr 1-4 yrs 5-14 yrs 15-29 yrs 30-44 yrs 45-64 yrs ≥65 yrs All ages

1 Birth trauma and choking Drowning Drowning Road traffic

injuriesRoad traffic injuries

Cerebrovascular disease



2 Low birth weight Road traffic injuries

Road traffic injuries

Self-inflicted injuries


Ischaemic heart disease



3 Congenital heart anomalies

Lower respiratory infections

Leukaemia Drowning Ischaemic heart disease Lung cancer

Chronic obstructive pulmonary disease


4 Lower respiratory infections

Congenital heart anomalies

Congenital heart anomalies Falls Liver cancer Liver cancer Lung cancer Lung cancer

5 Road traffic injuries Falls Falls Leukaemia Lung cancer Road traffic

injuriesHypertensive heart disease Liver cancer

6 Meningitis LeukaemiaLower respiratory infections


Self-inflicted injuries Stomach cancer Stomach cancer Hypertensive

heart disease

7 Anorectal atresia Poisonings Poisonings Ischaemic heart disease Falls


Liver cancer Stomach cancer

8 Falls Epilepsy Self-inflicted injuries Poisonings Poisonings Esophagus canc

erLower respiratory infections

Road traffic injuries

9 Down's syndrome Fires Endocrine disorder Liver cancer Stomach cancer Diabetes Diabetes Esophagus cancer

10 Diarrhea Meningitis Meningitis Congenital heart anomalies Liver cirrhosis Hypertensive

heart diseaseEsophagus cancer Diabetes

11 Drowning Inflammatory heart disease Epilepsy Nephritis and

nephropathyNephritis and nephropathy

Colon and rectum cancers



12 Protein-energy malnutrition

Lymphomas and multiple myeloma


Interpersonal violence Breast cancer Self-inflicted

injuries Falls Colon and rectum cancers

13 Leukaemia Protein-energy malnutrition

Nephritis and nephropathy Epilepsy Leukaemia Liver cirrhosis

Alzheimer's disease and other dementia

Falls

14 Inflammatory heart disease

Interpersonal violence

Cerebrovascular disease Lung cancer Colon and

rectum cancers Falls Nephritis and nephropathy

Self-inflicted injuries

15 Esophageal atresia

Nephritis and nephropathy

Interpersonal violence


Drowning Breast cancer Road traffic injuries

Nephritis and nephropathy

16 Cleft Palate Diarrhea Inflammatory heart disease


Hepatitis B Nephritis and nephropathy

Self-inflicted injuries Liver cirrhosis

17 Poisonings Iron drficiency Fires Tuberculosis Diabetes Pancreatic cancer

Rheumatic heart disease

Alzheimer's disease and other dementia

18 Epilepsy Down's syndrome Diabetes Endocrine disor

der Cervical cancer Hepatitis B Pancreatic cancer Pancreatic cancer

19 Nephritis and nephropathy

Upper respiratory infection

Tuberculosis Stomach cancer Hypertensive heart disease Cervical cancer Liver cirrhosis Rheumatic heart

disease

20 Abdominal-wall defect

Birth trauma and choking




Lip, oral cavity and pharynx cancer

Peptic ulcer Drowning

Source: Global Burden of Disease 2013

SITUATION — Fatal injuries

Death rate for male in 2013

75.5604

1987 1992 1997 2002 2007 2012 0

20

40

60

80

100

120

140

92

57

73

37

111

76

Male Female Total

1990 1995 2000 2005 2010 2013

Death rate in 201356.69

Death rate for female in 2013

36.73Trend of injury death rate by gender in China from 1990 to 2013

Road traffic injuriesSelf-harmFallsDrowningExposure to mechanical forcesPoisoningsInterpersonal violenceOthers


Road traffic injuries37%

Self-harm 16%

Drowning9%

05

Falls15%

Others10%

SITUATION — Fatal injuries

Distribution of injury deaths by cause in China, 2013

Source: China injury prevention report; Gao Maolong et al. The meta analysis of elderly falls in China.

Injuries in students

35% - 50%

06

Injuries in community

16% - 22%Falls in elderlys

6% - 21%

Incidence of injuriesfrom different studies in China

Incidence

SITUATION — Nonfatal injuries

FallsRoad traffic injuriesBlunt injuriesKnife/Sharp injuriesAnimal injuriesIntentional injuriesBurnPoisoningsSuicideSuffocation/HangingFirearmDrowningUnknownOthers

Source: National Injury Surveillance System (NISS), 2015

Falls37%

Road traffic injuries16%

Knife/Sharp injuries9%

07

Blunt injuries11%

SITUATION — Nonfatal injuries

Animal injuries16%

Distribution of injury cases by cause from National Injury Surveillance System in China, 2015

Sorce: WANG Hao-chen et al. Chinese Injury Caused Disability Paradigm Shift: Based on National Sampling Surveys on Disability 2014

SITUATION — Disabilities 08

Proportion of disability caused by injuries in

China

9%

Injury disability

1987

Proportion of disability caused by injuries in

China

Injury disability

16%2006


SITUATION — GBD 09

1987 1992 1997 2002 2007 20120.00

1000.00

2000.00

3000.00

4000.00

5000.00

6000.00

7000.00

5082.01

2579.65

3938.17

1562.81

6151.51

3527.79

Male Female Total

1990 1995 2000 2005 2010 2013

Trend of DALYs rate of injuries by gender in China from 1990 to 2013

Age-standardized DALYs rate of injuries by province in China, 2013

Source: : Data Sets of Death Surveillance of China ,2014/Global Burden of Disease 2013

SITUATION

The burden of injury decreased from 1990 to 2013Injury burden0

1 Injury is the leading death cause of population aged 1-44

Injury02 Road traffic injury is the leading death

cause of injury of all-age populationRoad traffic injury0

3 Drowning is the leading death cause of injury in the children aged 1-17

Drowning04 Falls is the leading death cause of injury

in the elderly aged 70 and aboveFalls0

5

10

Situation

11

Challenge

Solution

Injury

Urban self-harm

Child injury

NeglectOccupational injury

……

2000 20130%

10%20%30%40%50%60%

36%

54%

Percentage of urban people

Source: China Statistical Yearbook, 2015.

CHALLENGE — Urbanization 12

2000 20100%

5%

10%

15%

20%

25%

8.05%

21.88%

Percentage of rural

left-behind children

1990 20050

20 40 60 80

100 120 140 160 180

80

161

Number of

couples of divorce

(100,000)

2008 20150

5,000

10,000

15,000

20,000

25,000

30,000 22542

27747

Number of

migrant workers

(100,000)

Road0

70

140

210

280

350

420

490

Vehicles Drivers0

5000

10000

15000

20000

25000

30000

35000

Road traffi

c injur

y

Source: Statistic annual report on road traffic accident 2014, Traffic management bureau of Ministry of Public Security

CHALLENGE — Motorization 13

Vehicles Drivers0

5000

10000

15000

20000

25000

30000

35000

Road0

70

140

210

280

350

420

490

Number of vehicles (10 000) Length of roads (10 000 )

Number of drivers (10 000)

2000 2014

Source: National Bureau of Statistics of the People’s Republic of China

CHALLENGE — Aging

19951996

19971998

19992000

20012002

20032004

20052006

20072008

20092010

20112012

20132014

20150%

2%

4%

6%

8%

10%

12%

Trend of percentage of the elderly aged 65+ in China from 1995 to 2015

Elderly Injury

Falls

Road traffic injury

Self-harmAbuse

……4.3%

14

CHALLENGE——Unbalance

Need Supply

Policy

Finance

Human resource

Injury

Burden

Need Supply

15

CHALLENGE

Culture

Social norms

Behavior ……

16

Situation

17

Challenge

Solution

Evidence Model Support Team Cooperation

Evidence Model Support Team CooperationEvidence Model Support Team CooperationEvidence Model Support Team CooperationEvidence Model Support Team CooperationEvidence Model Support Team CooperationEvidence Model Support Team Cooperation

SurveillanceSurveyEvaluationResearch

Evidence-based

Issue-oriented

Target population focused

Multi-sectoral cooperation and Win-win

Entire Society Participation

Policy consultation

Technical assistance

NHFPC

Local CDC

Other Government departmentsWorking

guidelines and toolsPolicy

consultationTechnical assistance

Working guidelines and

tools

Nationwide capacity building workshops and seminars

Person-times CDC staff were trained

Certifications of National Continuing Education Credits

191500

900

SOLUTIONWe did …We work together …We promise.

18

SOLUTIONWe promise.

GGoverGovernmeGovernmentProfessional organProfessioProfessional organizations

Public

19

SAVING LIVESThanks!Dr. Leilei DuanEmail: [email protected]

leilei duan: future challenges and solutions for safety in china

Science