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Innocenti Report Card No 2. February 2001. UNICEF Innocenti Research Centre, Florence, Italy
UNICEF has recently (February 2001) published the second of its “Innocenti Report Cards” entitled A league table of child deaths by injury in rich nations. It produces, for the first time, a standardized league table of the wealthiest nations (26 of the 29 OECD member states) ranking them according to deaths from unintentional and intentional injuries in 1–14 year old children. Using mortality data from WHO, injury deaths per 100 000 children for the latest five year period, 1991–95, are presented, together with the rates for 1971–75. Many other data are presented, including a comparative table on national legislation related to injury prevention measures, and another which highlights where countries are ahead or behind in reducing deaths from specific causes.
Although there may be limitations related to the way the data are collected, the league table reveals that Sweden, the UK, Italy and the Netherlands fare best, with death rates below seven per 100 000. The worst are the USA, Portugal, Mexico and South Korea, where rates are three to four times higher. Variations are also shown in the relative progress made by OECD communities between 1971–75 and 1991–95. Canada has performed better than the USA in reducing child injury death rates; Australia better than New Zealand. Germany has performed best with rates falling by more than 70%.
The UNICEF report highlights the likely strong association between injury deaths and social deprivation. However, it stresses the paucity of data at national levels linking injury death with the social and economic circumstances of families. The difficulty of identifying exactly which children are most at risk leads UNICEF to conclude that “all injury prevention policy [is] pitifully under-informed”.
Although concerned with the situation in the wealthiest countries, the report concludes with a section on low income countries, pointing out that this is where 98% of all child injury deaths occur. UNICEF estimates that in the case of traffic accidents, 10 000 children are killed each year in rich nations, for the rest of the world, the figure is close to 240 000 per year.
While acknowledging the progress made in reducing child injury death rates since the 1970s in OECD countries, the comparative data presented by UNICEF shows the wide gaps in progress made by wealthy countries. Many still have a long way to go before they match the rates found in Sweden, the UK, Italy, and the Netherlands.
The Report Card provides an advocacy tool, which can be used to stimulate interest internationally in childhood injury.
Copies of the Report Card are available from the web at: http://www.unicef-icdc.org./publications/index.html
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