Disparities in Under-Five Child Injury Mortality between Developing and Developed Countries: 1990-2013

Abstract

Objective: Using estimates from the 2013 Global Burden of Disease (GBD) study, we update evidence on disparities in under-five child injury mortality between developing and developed countries from 1990 to 2013.

Methods: Mortality rates were accessed through the online visualization tool by the GBD study 2013 group. We calculated percent change in child injury mortality rates between 1990 and 2013. Data analysis was conducted separately for <1 year and 1-4 years to specify age differences in rate changes.

Results: Between 1990 and 2013, over 3-fold mortality gaps were observed between developing countries and developed countries for both age groups in the study time period. Similar decreases in injury rates were observed for developed and developing countries (<1 year: -50% vs. -50% respectively; 1-4 years: -56% vs. -58%). Differences in injury mortality changes during 1990-2013 between developing and developed nations varied with injury cause. There were greater reductions in mortality from transport injury, falls, poisoning, adverse effects of medical treatment, exposure to forces of nature, and collective violence and legal intervention in developed countries, whereas there were larger decreases in mortality from drowning, exposure to mechanical forces, and animal contact in developing countries. Country-specific analysis showed large variations across countries for both injury mortality and changes in injury mortality between 1990 and 2013.

Conclusions: Sustained higher child injury mortality during 1990-2013 for developing countries merits the attention of the global injury prevention community. Countries that have high injury mortality can benefit from the success of other countries.

Keywords: child; global; injury; mortality.

Figure 1

Global under-five child injury mortality per 100,000 persons by age and country income, 1990–2013.

Figure 2

Percent change in under-five injury mortality between 1990 and 2013 by age, cause, and country income.

Figure 3

Injury mortality for children under 5 in 187 countries between 1990 and 2013. ^a Country labels ranked by mortality of 1990 in Figure 3a: Seychelles, Taiwan, Costa Rica, Syria, Solomon Islands, Vanuatu, United Arab Emirates, Egypt, Malaysia, Bahrain, Mauritius, Cuba, Fiji, Antigua and Barbuda, Samoa, Kuwait, Qatar, Thailand, Mauritania, Libya, Philippines, Saudi Arabia, Jamaica, The Bahamas, Honduras, Trinidad and Tobago, Georgia, Panama, Federated States of Micronesia, Grenada, Sao Tome and Principe, Paraguay, Chile, Kiribati, Namibia, Papua New Guinea, Eritrea, Barbados, Kazakhstan, Jordan, Uruguay, Saint Lucia, Myanmar, Senegal, Marshall Islands, Nicaragua, Togo, Azerbaijan, Saint Vincent and the Grenadines, Venezuela, South Africa, Ghana, Turkey, Sri Lanka, Dominican Republic, Lesotho, Laos, Cambodia, Sudan, Botswana, Guatemala, Madagascar, Tajikistan, Cape Verde, Turkmenistan, Armenia, Niger, Mexico, Zimbabwe, Timor-Leste, Cameroon, Tonga, Swaziland, The Gambia, Yemen, Congo, Guinea-Bissau, Tunisia, Belize, Uzbekistan, Ecuador, Kenya, Vietnam, Mali, Benin, El Salvador, Zambia, Cote d'Ivoire, Guinea, Iraq, Brazil, Guyana, Suriname, Argentina, Palestine, Central African Republic, Dominica, Colombia, Gabon, Nepal, Burundi, Algeria, Morocco, Democratic Republic of the Congo, Djibouti, Uganda, Tanzania, Haiti, Chad, Nigeria, Malawi, Equatorial Guinea, Afghanistan, Sierra Leone, Angola, Burkina Faso, Indonesia, Kyrgyzstan, Comoros, Bangladesh, Mongolia, Mozambique, Somalia, Pakistan, North Korea, India, Oman, Rwanda, China, Bhutan, Ethiopia, Iran, Peru, Maldives, Liberia, Lebanon, Bolivia. ^b Country labels ranked by mortality of 1990 in Figure 3(c): Vanuatu, Mauritius, Solomon Islands, Barbados, Samoa, Antigua and Barbuda, Seychelles, Malaysia, Uruguay, Fiji, Honduras, Syria, Trinidad and Tobago, Cuba, Bahrain, Grenada, The Bahamas, Paraguay, Costa Rica, Egypt, Dominica, Taiwan, Saint Lucia, Kuwait, Jamaica, Chile, Papua New Guinea, Federated States of Micronesia, Thailand, United Arab Emirates, Philippines, Saint Vincent and the Grenadines, Tonga, Argentina, Marshall Islands, Belize, Dominican Republic, Sao Tome and Principe, Venezuela, Mexico, Sri Lanka, Kiribati, Brazil, Guatemala, Qatar, El Salvador, Cape Verde, Panama, Lesotho, Guyana, Turkey, Botswana, Kenya, Zimbabwe, Libya, Suriname, Mauritania, Nicaragua, South Africa, Palestine, Georgia, Azerbaijan, Swaziland, Namibia, Ghana, Cambodia, Ecuador, Iraq, Colombia, Myanmar, Tanzania, Kazakhstan, Haiti, Congo, Pakistan, Madagascar, Lebanon, Jordan, Kyrgyzstan, Morocco, Comoros, Algeria, Eritrea, Uzbekistan, India, Tunisia, Sudan, Tajikistan, Armenia, Cote d'Ivoire, The Gambia, Peru, Djibouti, Nepal, Timor-Leste, Zambia, Indonesia, Gabon, Yemen, Saudi Arabia, Mongolia, Senegal, Togo, Cameroon, Uganda, Guinea-Bissau, Turkmenistan, Vietnam, Laos, Chad, Benin, Oman, Burundi, Maldives, Sierra Leone, Guinea, North Korea, Mozambique, Somalia, Malawi, Central African Republic, Burkina Faso, China, Mali, Ethiopia, Nigeria, Liberia, Rwanda, Democratic Republic of the Congo, Iran, Equatorial Guinea, Bhutan, Niger, Afghanistan, Angola, Bolivia, Bangladesh.

Figure 3

Injury mortality for children under 5 in 187 countries between 1990 and 2013. ^a Country labels ranked by mortality of 1990 in Figure 3a: Seychelles, Taiwan, Costa Rica, Syria, Solomon Islands, Vanuatu, United Arab Emirates, Egypt, Malaysia, Bahrain, Mauritius, Cuba, Fiji, Antigua and Barbuda, Samoa, Kuwait, Qatar, Thailand, Mauritania, Libya, Philippines, Saudi Arabia, Jamaica, The Bahamas, Honduras, Trinidad and Tobago, Georgia, Panama, Federated States of Micronesia, Grenada, Sao Tome and Principe, Paraguay, Chile, Kiribati, Namibia, Papua New Guinea, Eritrea, Barbados, Kazakhstan, Jordan, Uruguay, Saint Lucia, Myanmar, Senegal, Marshall Islands, Nicaragua, Togo, Azerbaijan, Saint Vincent and the Grenadines, Venezuela, South Africa, Ghana, Turkey, Sri Lanka, Dominican Republic, Lesotho, Laos, Cambodia, Sudan, Botswana, Guatemala, Madagascar, Tajikistan, Cape Verde, Turkmenistan, Armenia, Niger, Mexico, Zimbabwe, Timor-Leste, Cameroon, Tonga, Swaziland, The Gambia, Yemen, Congo, Guinea-Bissau, Tunisia, Belize, Uzbekistan, Ecuador, Kenya, Vietnam, Mali, Benin, El Salvador, Zambia, Cote d'Ivoire, Guinea, Iraq, Brazil, Guyana, Suriname, Argentina, Palestine, Central African Republic, Dominica, Colombia, Gabon, Nepal, Burundi, Algeria, Morocco, Democratic Republic of the Congo, Djibouti, Uganda, Tanzania, Haiti, Chad, Nigeria, Malawi, Equatorial Guinea, Afghanistan, Sierra Leone, Angola, Burkina Faso, Indonesia, Kyrgyzstan, Comoros, Bangladesh, Mongolia, Mozambique, Somalia, Pakistan, North Korea, India, Oman, Rwanda, China, Bhutan, Ethiopia, Iran, Peru, Maldives, Liberia, Lebanon, Bolivia. ^b Country labels ranked by mortality of 1990 in Figure 3(c): Vanuatu, Mauritius, Solomon Islands, Barbados, Samoa, Antigua and Barbuda, Seychelles, Malaysia, Uruguay, Fiji, Honduras, Syria, Trinidad and Tobago, Cuba, Bahrain, Grenada, The Bahamas, Paraguay, Costa Rica, Egypt, Dominica, Taiwan, Saint Lucia, Kuwait, Jamaica, Chile, Papua New Guinea, Federated States of Micronesia, Thailand, United Arab Emirates, Philippines, Saint Vincent and the Grenadines, Tonga, Argentina, Marshall Islands, Belize, Dominican Republic, Sao Tome and Principe, Venezuela, Mexico, Sri Lanka, Kiribati, Brazil, Guatemala, Qatar, El Salvador, Cape Verde, Panama, Lesotho, Guyana, Turkey, Botswana, Kenya, Zimbabwe, Libya, Suriname, Mauritania, Nicaragua, South Africa, Palestine, Georgia, Azerbaijan, Swaziland, Namibia, Ghana, Cambodia, Ecuador, Iraq, Colombia, Myanmar, Tanzania, Kazakhstan, Haiti, Congo, Pakistan, Madagascar, Lebanon, Jordan, Kyrgyzstan, Morocco, Comoros, Algeria, Eritrea, Uzbekistan, India, Tunisia, Sudan, Tajikistan, Armenia, Cote d'Ivoire, The Gambia, Peru, Djibouti, Nepal, Timor-Leste, Zambia, Indonesia, Gabon, Yemen, Saudi Arabia, Mongolia, Senegal, Togo, Cameroon, Uganda, Guinea-Bissau, Turkmenistan, Vietnam, Laos, Chad, Benin, Oman, Burundi, Maldives, Sierra Leone, Guinea, North Korea, Mozambique, Somalia, Malawi, Central African Republic, Burkina Faso, China, Mali, Ethiopia, Nigeria, Liberia, Rwanda, Democratic Republic of the Congo, Iran, Equatorial Guinea, Bhutan, Niger, Afghanistan, Angola, Bolivia, Bangladesh.