Abstract

The English-speaking Caribbean sub-region comprises 18 nations of varying population sizes (from 6000 to 3 million persons) and stages of economic development but similar cultures as former British colonies. Three decades have wrought further changes, many impacting on health, especially injuries and violence.

This paper aims to describe the epidemiology of fatal injuries in the sub-region over three decades, 1985–2014, highlighting changes in the mortality profile and exploring possible associations with socio-economic and other environmental factors.

This will be done by reviewing the death certificates of the countries, extracting data on the demographics of the deceased, the external cause of death and details of the circumstances of the injury event.

Injury mortality tends to reflect the physical nature of the country, its level of economic development and cultural norms of the time. In the 1980s, fatal injuries were mostly unintentional. Fires and poisonings featured among injury deaths (especially in children) in the smaller, less developed nations, drownings among those to whom refugees fled from deteriorating economic situations, and pedestrian deaths when road traffic collisions occurred. With growing economic prosperity later, vehicular traffic increased resulting in more fatalities among occupants. With growth also came greater external influences that have reshaped cultural norms and have spawned a burgeoning underground economy to address perceived income and social inequalities. The result has been an increase in homicides, especially among young males. The physical environment has also impacted on injury mortality. Hurricanes and storms and the occasional volcano have all contributed to injury mortality in the Caribbean.

It is hoped that this analysis of three decades of data will not only explain the past but indicate future preventive measures for the diverse scenarios that present to the 18 countries and nearly 7 million people of the English-speaking Caribbean.