Relationship between economic development and risk of injuries in older adults and the elderly. A global analysis of unintentional injury mortality in an epidemiologic transition perspective

Eur J Public Health. 2005 Oct;15(5):454-8. doi: 10.1093/eurpub/cki014. Epub 2005 Jul 21.


Background: Injury is recognized as an important public health problem not only in high-income countries, but also in low- and middle-income countries. Other studies have shown inverse association between economic development and unintentional injury mortality (UIM) among children and young adults. In this study we aimed to examine the association between economic development and UIM rates among 45+ years-old populations within the theoretical framework of epidemiologic transition.

Methods: The World Health Statistics Annual 1996 was used as the main source of data. The relationship between UIM rates and gross national product (GNP) per capita was studied by using two methods: (i) with regression analysis, and (ii) by categorizing the data in four income-based country groups and the comparison of differences in their mean values. The ages were divided into four sub-groups: 45-54 years, 55-64 years, 65-74 years and 75+ years.

Results: UIM rates were inversely correlated with GNP per capita in 45-54, 55-64 and 65-74 year-olds for both sexes. On the other hand, among the 75+ years populations for both sexes, the association between GNP per capita and UIM rates was positive (male, r = 0.234, and female, r = 0.337).

Conclusion: Our study suggests that UIM rates shows deviating patterns across age groups. UIM exhibits declining rates among younger age groups by economic development which is consistent with what could be expected from the epidemiologic transition model, while injuries in older groups appear to increase by economic development. These findings imply that unintentional injury, as a whole, is not a homogeneous phenomenon from an epidemiological transition perspective.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Developing Countries / economics*
  • Female
  • Global Health
  • Humans
  • Male
  • Middle Aged
  • Public Health
  • Regression Analysis
  • Risk Factors
  • Socioeconomic Factors
  • Wounds and Injuries / epidemiology
  • Wounds and Injuries / mortality*