The Global Macroeconomic Burden of Burn Injuries

Abstract

PURPOSE: The objective of this study was to quantify the global macroeconomic burden of injuries inflicted by fire, heat, and hot substances. BACKGROUND: Over nine million people suffer from thermal injuries annually across the world. Among those injured, 90% of mortality occurs in low- and middle-income countries (LMICs). The economic impact of the morbidity and mortality incurred as a result of such injuries remains unclear. Quantifying the financial impact of these injuries can educate government and non-governmental organization funding initiatives designed to increase access to care. METHODS: Data on incidence, mortality, and disability adjusted life years (DALYs) from injuries caused by fire, heat, and hot substances were collected from the Global Burden of Disease Study 2019. The global macroeconomic burden of burns in the form of welfare lost was calculated by multiplying GDP per capita and DALYs for 190 individual countries. Gross domestic product (GDP) per capita adjusted for purchasing power parity (PPP) data were collected from the World Development Indicator Database. Temporal trends from 2009 to 2019 were evaluated with a specific focus on sub-Saharan Africa and South Asia. RESULTS: In 2019, the incidence of burns was 1.2 million in South Asia and 1.3 million in sub-Saharan Africa compared with 0.5 million cases in the United States. Mortality rates were higher in both South Asia (2.6 per 100 patients) and sub-Saharan Africa (1.8 per 100 patients) than in the United States (0.7 per 100 patients). Between 2009 and 2019, the incidence of burns increased by 3.1% in sub-Saharan Africa and decreased by 4.0% in South Asia. Burn-related mortality decreased between 2009 and 2019 in both sub-Saharan Africa (20.0%) and South Asia (8.6%). Lifetime burden of disease due to burn injuries was 1,617,220 DALYs for sub-Saharan Africa and 1,876,506 DALYs for South Asia. In 2019, 11.7 billion USD in South Asia and 6.1 billion USD in sub-Saharan Africa were lost due to burns. This was equivalent to 0.10% and 0.15% of GDP, respectively. Welfare losses due to burns as a share of GDP within specific South Asian economies were 0.12% for India, 0.04% for Nepal, 0.09% for Pakistan, 0.07% for Bhutan, and 0.06% for Bangladesh. Welfare losses were highest in Papua New Guinea, equivalent to 0.63% of GDP. CONCLUSIONS: While mortality rates due to burns are decreasing over time, the impact on GDP remains significant; the impact on GDP exceeds that due to cervical cancer and HIV in South Asia and tuberculosis in sub-Saharan Africa. Temporal trends indicate that progress has been made in the treatment of burns in these regions. Additional resources, including intensive care units, skin banks, and hospital beds, may enhance care for patients with more severe burns and address the magnitude of injuries each year. In the setting of rising incidence, efforts designed to prevent burn injuries in the form of education are required. To convince governments to fund such initiatives in resource-limited environments, demonstrating the financial impact of burn injuries on a population level is one approach.