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More than 20,000 children in rich countries will die from injuries in the next twelve months, says UNICEF

UNICEF publishes first league table of child deaths from injury

6 February 2001: UNICEF publishes today the first league table of child deaths by injury and concludes that injuries kill over 20,000 children aged 1 to 14 every year in the world's wealthiest nations. The new research, published in the UNICEF Innocenti Report Card, provides the most comprehensive estimates so far of child injury deaths across the member countries of the OECD.

In every single industrialized country, injury has now become the leading killer of 1 to 14 year-olds - accounting for almost 40 per cent of deaths in that age group. And for every injured child who dies, many more live on with varying degrees of disability and trauma.

The UNICEF league table ranks countries according to their injury death rates for children aged 1 to 14. Sweden, the United Kingdom, Italy and the Netherlands occupy the top four places - all with injury death rates below 7 per 100,000. At the bottom of the league are the United States and Portugal, where the rate of child injury deaths is over twice the level of the leading countries, and South Korea where the rate is four times higher.

Overall the likelihood of a child dying from injury has been falling steadily in recent years. But different nations have been progressing at very different speeds in the battle to save young lives. At least 12,000 child deaths a year could still be prevented if all OECD countries had the same child injury death rate as Sweden - which is at the top of the league. If the members of the European Union were all to achieve the same safety levels as Sweden approximately 1,600 young lives would be saved annually in Europe alone. France and Germany could each prevent around 400 child deaths. The United States could save 4,700 children a year.

In general the league table shows a clear relationship between child injury death rates and national wealth; but it also shows that this relationship is far from fixed. Two of the richest countries Switzerland and Canada find themselves in the bottom half of the league. Greece and Portugal have similar GDP per capita, but Greece has a child injury death rate less than half that of Portugal.

By comparing data from different countries, the new research asks what can be learned about the causes of child injury deaths and examines the policies that have contributed to lower rates in the top ranking countries. UNICEF finds that even those countries in the top half of the child safety league table could do better in preventing child deaths from specific causes. For example, the United Kingdom, with a good record overall, compares badly to other countries on the rate of children dying in fires. Germany has a child death rate from drowning that is almost three times higher than in Italy.

The UNICEF report asks both what is killing children and which children are dying. Although most countries lack data, it appears that the risk of child injury death rises steeply with poverty. The likelihood of a child being injured or killed is also associated with single parenthood, low maternal education, low maternal age at birth, poor housing, large family size and parental drug or alcohol abuse. Some research shows children of indigenous peoples to be at significantly higher risk. An Australian study showed a 75 times greater risk of death by fire among aboriginal children and another study has shown the risk of traffic injury among Hispanic children in the United States to be more than three times higher than the rate for non-Hispanic children.

Gender also plays a part. Death through injury is much more common for boys than for girls. UNICEF finds that in the OECD as a whole, boys aged 1 to 14 were 70 per cent more likely than girls to die from injuries. The difference between the sexes is greatest for older children, a phenomenon explained either by boys taking more risks or by parents or schools being more permissive with boys than girls. But an extraordinary finding is that the gender gap appears even among the youngest children. A boy aged 1 to 4 is already 40 per cent more likely to die of injury than a girl.

But overall, there is a lack of adequate data and research into exactly which children are most at risk and this leaves all injury prevention policy pitifully under-informed, says UNICEF.

The most common causes of child injury deaths include drowning, fire, falls, poison and intentional injury. But in every individual nation the spectrum is dominated by road traffic accidents which account in total for 41 per cent of all child deaths by injury throughout the industrialized world.

For all the major areas of risk there are proven ways of reducing both the likelihood and the severity of child injury. But, says UNICEF, many proven strategies for injury prevention are inadequately implemented.

In an attempt to assess the commitment of rich nations to the cause of child safety, UNICEF commissioned a study recording the extent to which each country has legislated in favour of certain well-known safety measures - cycle helmets, speed limits in built up areas, child safety seats in cars, seat-belt wearing by children, child safety packaging for pharmaceuticals, smoke detectors in homes, and playground safety standards. It finds that not one country has legislated in all seven of these obvious areas for child protection and some have acted in as few as three.

Such inadequate implementation of already proven strategies for injury prevention exposes a
need for renewed commitment to the cause of child safety in the world's richest nations, says UNICEF.

Finally, the analysis of child injury deaths in rich nations carries with it vital lessons for the developing world where an estimated one million children under 15 die each year from injuries. The rate of child deaths in traffic accidents is today more than five times higher in Africa than in the European Union even though Africa is still at the beginning of the growth curve in vehicle ownership. Millions of child deaths in the developing world could be prevented by learning the lessons acquired so painfully by the industrialized nations, says UNICEF.

This publication is the second in a series of Innocenti Report Cards, designed to monitor the performance of the industrialized countries in meeting the needs of their children. Each Report Card presents and analyses league tables ranking the performance of rich nations against critical indicators of child well being. The first report in the series published in June 2000 focused on child poverty. The next Report Card will investigate teenage pregnancy - a critical factor in a cycle of poverty, educational disadvantage and social exclusion among children in rich nations.

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For further information, please contact:

Patrick McCormick, Communication Officer, UNICEF Florence, Italy
tel: 0039-055-2033354

Jehane Sedky-Lavandero, UNICEF Media, New York, (212) 326-7269