Childhood injury surveillance in the UK is under-resourced and lags behind other European countries, say experts in this week's BMJ, ahead of UK Child Safety Week on 23 June.
Most injury is avoidable and preventable, write Graham Kirkwood and Allyson Pollock from the Centre for International Public Health Policy at the University of Edinburgh, but because the UK does not have a comprehensive childhood injury surveillance system, the causes, risks factors, and consequences of childhood injury are unknown. This has made it difficult to implement evidence based injury prevention strategies, they argue.
In the UK, unintentional injury is a leading cause of death and injury and the most common cause of hospital admission in children and accounts for two million accident and emergency department visits each year at a cost of £146 million to the NHS. And it is children from the poorest families who suffer the most—death rates from unintentional injury are three times higher in children from the poorest families.
The Audit Commission, Healthcare Commission and the European Child Safety Alliance have all voiced their concerns over the fragmented nature of UK injury policy and the lack of monitoring and surveillance systems.
The authors point out that part of the problem is that responsibility for children is shared across many sectors and agencies—including Local Education Authorities, the NHS, and the Health and Safety Executive—with no one integrated injury surveillance system.
But according to the authors, the key issue is the lack of political support for surveillance systems essential for monitoring childhood injury at country level, despite the UK government prioritising the health and well-being of children.
The authors suggest that because many non-fatal unintentional injures in children result from sport, the 2012 London Olympics could act as a catalyst. Not only, as the government hopes, to encourage physical activity and help lower levels of obesity in children in the UK, but also to promote the development of injury surveillance systems and prevention strategies to help children participate in 'safe' sport and reduce inequalities in injury rates across the social classes.
Examples of good practice such as Sweden, the Netherlands and Denmark all have well established area based population injury surveillance systems and the lowest mortality rates from unintentional injury in children in Europe, the highest levels of sport participation, and Sweden has half the obesity levels of the UK.
"If the UK governments are really committed to the health and wellbeing of children and to ameliorating inequalities then much more is needed…[they] must now find the resources to develop population based injury surveillance systems so that the true incidence, causes, risk factors, and long-term sequelae of injuries can be used to inform evidence based intervention", they conclude.