II About the report
III Next steps: Using the report
--submitted by Kathy Blair, Ontario Injury Prevention Resource Centre, SMARTRISK
A major new Canadian research document outlining the high cost of injury in this country is now available. The following article offers an overview of the recently released report, The Economic Burden of Injury in Canada, published by SMARTRISK.
Partners across the country helped make this study possible, including the Government of Ontario and the Ontario Public Health Association. The new Burden report updates and builds on the original national study published in 1998. SMARTRISK, which also houses the Ontario Injury Prevention Resource Centre, followed that 1998 national study up with individual Burden reports for most provinces, including for Ontario.
This article will offer highlights of the Burden’s Canadian and Ontario data, along with suggestions for use by public health professionals. Print copies have already been mailed to all health units in Ontario. In addition, the full document is available to download (see Resources section).
II About the report
Purpose of the report
While the greatest burden of injury is borne by those whose health, well-being and life potential are directly diminished or destroyed by injury, economic burden studies enable us to calculate the broader societal burden that injury imposes. These include the cost pressures on our health care system and foregone human potential in terms of years of life lost and diminished labour market productivity and earnings. The costs that emerge from this analysis are the costs of inaction – the price we all pay for failing to address injuries that are largely predictable and preventable.
What’s new in 2009
This 2009 study builds on the original report and offers several new and useful features:
- Data on intentional injuries (i.e., violence and suicide/self-harm) are included this time, in addition to unintentional injuries, such as transportation and falls.
- National data are provided, as are provincial breakdowns, so comparisons across provinces and to the country as a whole can be readily made.
- The methodology continues to use the Electronic Resource Allocation Tool, employing a human capital approach from a societal perspective. A societal perspective means that the analysis focuses on the cost of the injuries to the economy, not the cost of the event. For example, the costs of a person injured in a car crash would include the costs to the health care system and loss of productivity to the economy but not the cost of repairing the car. New this time, this report makes use of updated International Classification of Disease-10 codes.
Data highlights: Canada, 2004
Those working to prevent injury can take heart that progress has been made in recent years: data analysis over the decade between the two national Burden reports reveals a decrease of 10.9% in the overall death rate due to injury between 1995 and 2004. Other figures, including hospitalization and emergency department data, are impossible to compare, unfortunately, due to differences in data collection and missing data.
The national economic burden per capita in 2004 was $621 and the potential years of life lost due to injury were 993.3 per 100,000 population. Other key figures include:
- 13,667 people died of injury, 211,768 were hospitalized and a further 3,134,025 were treated in emergency departments.
- 62,563 suffered permanent, partial disabilities and 5,023 were left with a permanent, total disability.
- Total cost of injury, including direct (health care) and indirect costs (lost productivity) amounted to $19.8 billion, with direct costs accounting for 54% of the total and indirect costs the remaining 46%.
- Unintentional injuries (transportation, falls, drowning, fire/burns, unintentional poisoning, sport and other unintentional causes) accounted for 81% of injury costs, with intentional injuries responsible for 17% and undetermined intent for the remaining 2%.
Key figures for Ontario, 2004
Ontario compares favourably to the national injury burden rate with a per capita cost of $551 per person and 755.4 potential years of life lost – the lowest potential years of life lost of the provinces. Notably, Ontario achieved the lowest rate of transport related deaths among the provinces at 7.6 deaths per 100,000 population. Other key figures for Ontario include:
- 4,643 injury deaths, 71,727 people hospitalized and 1,196,505 treated for injuries in emergency.
- 22,029 people suffered permanent, partial disabilities and 1,741 suffered permanent, total disabilities.
- Total cost to Ontarians amounted to $6.8 billion. Direct costs accounted for 54% of total injury costs while indirect were 46% of total costs.
- Falls were the costliest cause of injury, at $2.1 billion, 1,065 deaths and 36,450 hospitalizations and 342,889 non-hospitalizations.
- Transport incidents had the second highest burden at $1.1 billion, 934 deaths and 8,894 hospitalizations.
- Suicide and self-harm was next at $842 million, 1,021 deaths and 7,052 hospitalizations.
III Next steps: Using the report
Historically, injury is an issue that has been under-recognized in Canada and thus under-funded and under-researched. However, SMARTRISK has been encouraged by the growing attention that governments across Canada are giving to injury and by the increasing number of front line prevention programs that take aim at injury where it lives in our communities.
Drawing attention to the billions of dollars that injury costs the Canadian health care system and the economy as a whole helps to enlighten policy makers to the urgency of the issue. Injury prevention practitioners are encouraged to use the data to urge policy makers at all levels of government to establish public priorities for investment and action.
The data also allow injury prevention champions, practitioners and policy makers to appreciate the true extent of injury in Canada, to understand in detail who and where it strikes, and to develop effective strategies to stop it. Local practitioners can compare their local data to provincial and national averages to gain understanding of where their greatest needs might be.
With an annual economic burden of about $6.8 billion in Ontario and $19.8 billion for Canada as a whole, investing resources in injury is clearly warranted. And that’s without even considering the incalculable physical and emotional costs of injury on individuals, their families, friends and colleagues. Canada would surely benefit from a comprehensive, national injury prevention strategy and complementary strategies at the provincial level. Injuries can be prevented, lives saved and a significant drain on our public resources stopped.