Background Injury mortality in South Africa, particularly homicide and road traffic injuries are still among the highest in the world. Although South Africa's population is gradually ageing, the safety of older persons is often neglected in favour of other vulnerable groups such as women and children. The study aims to describe the extent and distribution of fatal injuries occurring in older adults, in the four largest South African metropolitan centres.
Methods The study is a register-based cross sectional investigation of causes of injury mortality for adults 60 years and older, as reported in the National Injury Mortality Surveillance System for four cities, for the period 2001 to 2006. Poisson regression was used to assess relative risk estimates among age and population groups, sex and cities. The role of alcohol and time and place of death was also investigated.
Results Leading causes of death were pedestrian accidents (28.6%), homicide (20.3%) and suicide (11.4%). Males were found to be at higher risk for most external causes of death, markedly homicide (RR 2.0, 95% CI 1.8 to 2.2), suicide (RR 2.2, 95% CI 2.1 to 2.5) and pedestrian accidents (RR 1.8, 95% CI 1.6 to 1.9). Fatal injury patterns differed among cities and population groups.
Conclusions The study highlights the unique challenges in providing a safe environment for the older population in a developing country. Further investigation is required to assess the association between injury-related mortality and poverty/deprivation and ethnicity among older people, as well as explain geographic variations in injury patterns.
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