|
Abstract
|
In The Lancet Healthy Longevity, Samar Al-Hajj and colleagues investigate injury burden in people aged 50 years or older in the Eastern Mediterranean region, and highlight increased rates of disability-adjusted life years due to injuries in this region compared with global rates; differences in rates between the countries in the region are also shown.
The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), from which data are derived in the study by Al-Hajj and colleagues, provides estimates for the burden of diseases and injuries, and for the burden attributable to different risk factors by cause, age, sex, location, and time, but does not provide estimates based on birth cohort. The cohort effect is important in assessment of health in older adults, because health in this population depends on lifestyle and different exposure to risk factors throughout the life course. Those birth cohorts that experience war or other types of conflicts have sustained effects for several years or even the whole life course. Such effects include both the direct physical or mental consequences of conflicts, such as lifelong bodily injuries or chronic anxiety disorders, and indirect health complications mediated by the factors related to conflicts, such as displacement, mass migration, land occupation, and disruption of social services. Other studies have demonstrated significant independent influences of age, birth cohort, and period effects on unintentional injuries, such as death from motorcycle injuries in traffic accidents, as well as on risk factors of injuries, such as occupational risks and decreased bone density; programmes against these risk factors should usually start before elderly to prevent poor outcomes efficiently in older age. This means that when we describe injuries in older people for several consecutive years, we also need to consider their birth cohorts; people of the same age group but from different birth cohorts might be affected differently by injuries, especially when there is a long time difference between the first and the last birth cohorts included.
In the Eastern Mediterranean region, a commission of Social Determinants of Health, initiated by the WHO regional office, published the Build back fairer report, which includes a conceptual framework, different recommendations, and suggested actions for improving the social determinants of health and for reducing health inequities; healthy ageing as a life condition, and conflict and consequences thereof as structural drivers have been recognised by the commissioners as important fields for interventions in the region.
Conflicts, both within and between the countries, are more common in the Eastern Mediterranean region than in other places in the world. Since the beginning of the 21st century, all countries in this region have in some way been affected by war, armed conflict, or terrorism.5
Obviously, peace has a crucial role in reducing the burden of intentional injuries and its consequences in all age groups, and should be actively followed as a main objective; at the same time, other interventions, including the humanitarian and emergency assistance to affected populations, are also important to reduce the devastating effects of conflicts and terroristic attacks...
Language: en |