Dataset Information

Drowning mortality by intent: a population-based cross-sectional study of 32 OECD countries, 2012-2014.

ABSTRACT: OBJECTIVE:To compare the drowning mortality rates and proportion of deaths of each intent among all drowning deaths in Organisation for Economic Co-operation and Development (OECD) countries in 2012-2014. DESIGN:A population-based cross-sectional study. SETTING:32 OECD countries. PARTICIPANTS:Individuals in OECD countries who died from drowning. MAIN OUTCOME MEASURES:Drowning mortality rates (deaths per 100?000 population) and proportion (%) of deaths of each intent (ie, unintentional intent, intentional self-harm, assault, undetermined intent and all intents combined) among all drowning deaths. RESULTS:Countries with the highest drowning mortality rates (deaths per 100?000 population) were Estonia (3.53), Japan (3.49) and Greece (2.40) for unintentional intent; Ireland (0.96), Belgium (0.96) and Korea (0.89) for intentional self-harm; Austria (0.57), Korea (0.56) and Hungary (0.44) for undetermined intent and Japan (4.35), Estonia (3.70) and Korea (2.73) for all intents combined. Korea ranked 12th and 3rd for unintentional intent and all intents combined, respectively. By contrast, Belgium ranked 2nd and 15th for intentional self-harm and all intents combined, respectively. The proportion of deaths of each intent among all drowning deaths in each country varied greatly: from 26.2% in Belgium to 96.8% in Chile for unintentional intent; 0.7% in Mexico to 57.4% in Belgium for intentional self-harm; 0.0% in nine countries to 4.9% in Mexico for assault and 0.0% in Israel and Turkey to 38.3% in Austria for undetermined intent. CONCLUSIONS:A large variation in the practice of classifying undetermined intent in drowning deaths across countries was noted and this variation hinders valid international comparisons of intent-specific (unintentional and intentional self-harm) drowning mortality rates.

SUBMITTER: Hsieh WH

PROVIDER: S-EPMC6059339 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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Drowning mortality by intent: a population-based cross-sectional study of 32 OECD countries, 2012-2014.

Hsieh Wan-Hua WH Wang Chien-Hsing CH Lu Tsung-Hsueh TH

BMJ open 20180723 7

<h4>Objective</h4>To compare the drowning mortality rates and proportion of deaths of each intent among all drowning deaths in Organisation for Economic Co-operation and Development (OECD) countries in 2012-2014.<h4>Design</h4>A population-based cross-sectional study.<h4>Setting</h4>32 OECD countries.<h4>Participants</h4>Individuals in OECD countries who died from drowning.<h4>Main outcome measures</h4>Drowning mortality rates (deaths per 100 000 population) and proportion (%) of deaths of each ...[more]

PMID: 30037871

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Project description:BackgroundTo examine unintentional drowning mortality by age and body of water across 60 countries, to provide a starting point for further in-depth investigations within individual countries.MethodsThe latest available three years of mortality data for each country were extracted from WHO Health Statistics and Information Services (updated at 13 November 2013). We calculated mortality rate of unintentional drowning by age group for each country. For countries using International Classification of Disease 10 (ICD-10) detailed 3 or 4 Character List, we further examined the body of water involved.ResultsA huge variation in age-standardised mortality rate (deaths per 100 000 population) was noted, from 0.12 in Turkey to 9.19 in Guyana. Of the ten countries with the highest age-standardised mortality rate, six (Belarus, Lithuania, Latvia, Russia, Ukraine and Moldova) were in Eastern Europe and two (Kazakhstan and Kyrgyzstan) were in Central Asia. Some countries (Japan, Finland and Greece) had a relatively low rank in mortality rate among children aged 0-4 years, but had a high rank in mortality rate among older adults. On the contrary, South Africa and Colombia had a relatively high rank among children aged 0-4 years, but had a relatively low rank in mortality rate among older adults. With regard to body of water involved, the proportion involving a bathtub was extremely high in Japan (65%) followed by Canada (11%) and the USA (11%). Of the 13 634 drowning deaths involving bathtubs in Japan between 2009 and 2011, 12 038 (88%) were older adults aged 65 years or above. The percentage involving a swimming pool was high in the USA (18%), Australia (13%), and New Zealand (7%). The proportion involving natural water was high in Finland (93%), Panama (87%), and Lithuania (85%).ConclusionsAfter considering the completeness of reporting and quality of classifying drowning deaths across countries, we conclude that drowning is a high-priority public health problem in Eastern Europe, Central Asia, Japan (older adults involving bathtubs), and the USA (involving swimming pools).

Project description:ObjectivesThe epidemiology of fatal drowning is increasingly understood. By contrast, there is relatively little population-level research on non-fatal drowning. This study compares data on fatal and non-fatal drowning in Australia, identifying differences in outcomes to guide identification of the best practice in minimising the lethality of exposure to drowning.DesignA subset of data on fatal unintentional drowning from the Royal Life Saving National Fatal Drowning Database was compared on a like-for-like basis to data on hospital separations sourced from the Australian Institute of Health and Welfare's National Hospital Morbidity Database for the 13-year period 1 July 2002 to 30 June 2015. A restrictive definition was applied to the fatal drowning data to estimate the effect of the more narrow inclusion criteria for the non-fatal data (International Classification of Diseases (ICD) codes W65-74 and first reported cause only). Incidence and ratios of fatal to non-fatal drowning with univariate and Χ2 analysis are reported and used to calculate case-fatality rates.SettingAustralia, 1 July 2002 to 30 June 2015.ParticipantsUnintentional fatal drowning cases and cases of non-fatal drowning resulting in hospital separation.Results2272 fatalities and 6158 hospital separations occurred during the study period, a ratio of 1:2.71. Children 0-4 years (1:7.63) and swimming pools (1:4.35) recorded high fatal to non-fatal ratios, whereas drownings among people aged 65-74 years (1:0.92), 75+ years (1:0.87) and incidents in natural waterways (1:0.94) were more likely to be fatal.ConclusionsThis study highlights the extent of the drowning burden when non-fatal incidents are considered, although coding limitations remain. Documenting the full burden of drowning is vital to ensuring that the issue is fully understood and its prevention adequately resourced. Further research examining the severity of non-fatal drowning cases requiring hospitalisation and tracking outcomes of those discharged will provide a more complete picture.

Project description:A common approach for measuring the effectiveness of an education system or a school is the estimation of the impact that school interventions have on students' academic performance. However, the latest trends aim to extend the focus beyond students' acquisition of knowledge and skills, and to consider aspects such as well-being in the academic context. For this reason, the 2015 edition of the international assessment system Programme for International Student Assessment (PISA) incorporated a new tool aimed at evaluating the socio-emotional variables related to the well-being of students. It is based on a definition focused on the five dimensions proposed in the PISA theoretical framework: cognitive, psychological, social, physical, and material. The main purpose of this study is to identify the well-being components that significantly affect student academic performance and to estimate the magnitude of school effects on the well-being of students in OECD countries, the school effect being understood as the ability of schools to increase subjective student well-being. To achieve this goal, we analyzed the responses of 248,620 students from 35 OECD countries to PISA 2015 questionnaires. Specifically, we considered non-cognitive variables in the questionnaires and student performance in science. The results indicated that the cognitive well-being dimension, composed of enjoyment of science, self-efficacy, and instrumental motivation, as well as test anxiety all had a consistent relationship with student performance across countries. In addition, the school effect, estimated through a two-level hierarchical linear model, in terms of student well-being was systematically low. While the school effect accounted for approximately 25% of the variance in the results for the cognitive dimension, only 5-9% of variance in well-being indicators was attributable to it. This suggests that the influence of school on student welfare is weak, and the effect is similar across countries. The present study contributes to the general discussion currently underway about the definition of well-being and the connection between well-being and achievement. The results highlighted two complementary concerns: there is a clear need to promote socio-emotional education in schools, and it is important to develop a rigorous framework for well-being assessment. The implications of the results and proposals for future studies are discussed.

Project description:ObjectiveThe study investigates the trends in health-related inequalities in paid employment among men and women in different educational groups in 26 countries in 5 European regions.DesignIndividual-level analysis of repeated cross-sectional annual data (2005-2014) from the EU Statistics on Income and Living Conditions.Setting26 European countries in 5 European regions.Participants1 844 915 individuals aged 30-59 years were selected with information on work status, chronic illness, educational background, age and gender.Outcome measuresAbsolute differences were expressed by absolute differences in proportion in paid employment between participants with and without a chronic illness, using linear regression. Relative differences were expressed by prevalence ratios in paid employment, using a Cox proportional hazard model. Linear regression was used to examine the trends of inequalities.ResultsParticipants with a chronic illness had consistently lower labour force participation than those without illnesses. Educational inequalities were substantial with absolute differences larger within lower educated (men 21%-35%, women 10%-31%) than within higher educated (men 5%-13%, women 6%-16%). Relative differences showed that low-educated men with a chronic illness were 1.4-1.9 times (women 1.3-1.8 times) more likely to be out of paid employment than low-educated persons without a chronic illness, whereas this was 1.1-1.2 among high-educated men and women. In the Nordic, Anglo-Saxon and Eastern regions, these health-related educational inequalities in paid employment were more pronounced than in the Continental and Southern region. For most regions, absolute health-related educational inequalities in paid employment were generally constant, whereas relative inequalities increased, especially among low-educated persons.ConclusionsMen and women with a chronic illness have considerable less access to the labour market than their healthy colleagues, especially among lower educated persons. This exclusion from paid employment will increase health inequalities.

Dataset Information

Drowning mortality by intent: a population-based cross-sectional study of 32 OECD countries, 2012-2014.

Publications

Drowning mortality by intent: a population-based cross-sectional study of 32 OECD countries, 2012-2014.

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