Abstract
IntroductionWe investigate the links between health and injury in Thailand. This is important because of the high burden of injury in transitional countries and limited information for public health.MethodsWe analyse 2005 baseline and 2009, 4-year follow-up data from distance learning students of Sukhothai Thammathirat Open University residing nationwide (n = 60569). Injury was reported for the past year in both periods. Medical Outcome Study Short-Form (SF-8™) health status was reported and Physical and Mental Component Summary Scores (PCS and MCS) were calculated. Analyses used covariate-adjusted multivariate linear regression.ResultsIn 2009, increasing numbers of traffic injuries (0, 1, 2, 3, 4+) associated with declining PCS scores (49.8, 48.4, 46.9, 46.2, 44.0), along with a similar monotonic decline for MCS scores (47.6, 46.0, 44.2, 42.7, 40.6). A similar (but smaller) dose-response gradient was found between non-traffic injuries and SF-8 scores. Longitudinal analyses showed those with incident injury (no injury 2005, injury 2009) had lower PCS and MCS scores compared to those with no injury in both periods. Individuals with reverting injury status (injury 2005, no injury 2009) reported improvement in PCS and MCS scores over the four-year period.ConclusionWe found significant and epidemiologically important associations between increasing injury frequency and worse health in the past year, especially traffic injuries. Longitudinal 2005–2009 results were supportive and revealed statistically significant adverse 4-year effects of incident injury on health. If injury reverted over four years, low initial scores improved greatly. Findings highlight the importance of injury prevention as a public health priority.
Highlights
We investigate the links between health and injury in Thailand
Data derive from a research cohort of 87,134 distance-learning students aged between 15 and 87 years enrolled at Sukhothai Thammathirat Open University (STOU)
For both traffic and non-traffic injuries, we found a monotonic dose-response gradient between increasing number of injuries and decreasing Physical Component Summary (PCS) and Mental Component Summary (MCS) scores but we note that the magnitude of the gradient was much larger for traffic injuries
Summary
We investigate the links between health and injury in Thailand. This is important because of the high burden of injury in transitional countries and limited information for public health. Some 90% of the global injury incidence is in the lower and middle-income countries, especially those with emerging economies and undergoing transition from infectious disease to chronic disease and injury [1,2,3]. In such settings, injury is among the top ten contributors to the overall burden of disease [4,5,6,7,8]. Comprehensive injury prevention strategies in transitional developing country settings have not yet been defined. The consequences of non-fatal injuries on general health and quality of life remain largely unknown [22,23]
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