Abstract
BackgroundInjury is a growing public health concern in China. Injury death rates are often higher in rural areas than in urban areas in general. The objective of this study is to compare the injury mortality rates in urban and rural residents in Hubei Province in central China by age, sex and mechanism of injury.MethodsUsing data from the Disease Surveillance Points (DSP) system maintained by the Hubei Province Centers for Disease Control and Prevention (CDC) from 2006 to 2008, injury deaths were classified according to the International Classification of Disease-10th Revision (ICD-10). Crude and age-adjusted annual mortality rates were calculated for rural and urban residents of Hubei Province.ResultsThe crude and age-adjusted injury death rates were significantly higher for rural residents than for urban residents (crude rate ratio 1.9, 95% confidence interval 1.8-2.0; adjusted rate ratio 2.4, 95% confidence interval 2.3-2.4). The age-adjusted injury death rate for males was 81.6/100,000 in rural areas compared with 37.0/100 000 in urban areas; for females, the respective rates were 57.9/100,000 and 22.4/100 000. Death rates for suicide (32.4 per 100 000 vs 3.9 per 100 000), traffic-related injuries (15.8 per 100 000 vs 9.5 per 100 000), drowning (6.9 per 100 000 vs 2.3 per 100 000) and crushing injuries (2.0 per 100 000 vs 0.7 per 100 000) were significantly higher in rural areas. Overall injury death rates were much higher in persons over 65 years, with significantly higher rates in rural residents compared with urban residents for suicide (279.8 per 100 000 vs 10.7 per 100 000), traffic-related injuries, and drownings in this age group. Death rates for falls, poisoning, and suffocation were similar in the two geographic groups.ConclusionsRates of suicide, traffic-related injury deaths and drownings are demonstrably higher in rural compared with urban locations and should be targeted for injury prevention activity. There is a need for injury prevention policies targeted at elderly residents, especially with regard to suicide prevention in rural areas in Central China.
Highlights
Injury is a growing public health concern in China
The focus of this study is to describe and compare the injury mortality rates in urban and rural residents from 2006 through 2008 in Hubei Province, central China, by age, sex and mechanism of injury
This article has quantified the difference in the experience of injury mortality between rural and urban residents in Hubei Province, central China, with rural residents experiencing a higher injury burden
Summary
Injury is a growing public health concern in China. Injury death rates are often higher in rural areas than in urban areas in general. Using 10 years of national Disease Surveillance Points (DSP) data to examine fatal injury in China, Yang et al reported higher mortality rates among rural residents, with reported average annual age-adjusted death rates of 38.7 per 100,000 population for urban residents and 74.6 per 100,000 populations for residents of rural areas. Injury death rates in the central and western rural areas were higher than those in eastern rural areas [7]. Other studies both from national samples and local samples in China show higher injury mortality rates in rural areas [3,8,9,10,11,12] These studies are limited by the lack of details (gender, age group, and mechanism of injury etc.) on urban-rural disparities. Hu and colleagues reported differences in injury mortality by gender, age group, and mechanism between urban and rural residents [13], but the data used in this analysis were from the Chinese Vital Registration system which has better data quality in urban than in rural areas resulting in significant biases in the overall statistics [14]
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