International comparisons: we need to know a lot more
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, University of Otago Medical School, PO Box 913, Dunedin, New Zealand
- Correspondence to: Professor Langley
In response to the recently published UNICEF report on child injury deaths Ramsay asks “Do international comparisons help?” and concludes that provided countries occupying low positions are not stigmatised the comparison serves a purpose if only to raise awareness of child injury death.1 While increased awareness of one's country's performance relative to others may be a necessary condition for making progress on reducing injury, it would rarely be sufficient. Both the report and commentators struggle for explanations.2 They struggle since they lack the necessary information to, at least crudely, test their hypotheses. This article discusses some of the information that would greatly assist in this respect: more detailed analysis of deaths; details on person time exposure to hazards; information on safety behaviour; and information on engineering, legislation, enforcement, and education.
A closer look at selected injury deaths
The report highlights the fact that overall 41% of the deaths are due to motor vehicle traffic crashes. Accordingly it compares countries in terms of the motor vehicle traffic fatality rates. Unfortunately the report does not delve further into these rates for clues as to where countries may differ. For example, is the risk of crash in New Zealand relative to other countries similar for all classes of road users? To answer this some help is offered by previous papers in this journal that describe the fatal injury burden for England and Wales,3 New Zealand,4 Australia,5 and the United States.6 This group of countries includes one with the best record, England and Wales, and one with the worst, New Zealand.
Unintentional motor vehicle traffic crashes made the following contributions to each country's total injury death burden—New Zealand 43%, Australia 39%, United States 35%, and England and Wales 35%.
These reports show that occupants of cars and pedestrians contribute most to the motor vehicle traffic …
