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Childhood injury surveillance under-resourced, say experts

20 June 2008

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Childhood injury surveillance in the UK is under-resourced and lags behind other European countries, according to experts in this week’s British Medical Journal, 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.

The article says that in the UK, unintentional injury is a leading cause of death and injury and the most common cause of hospital admission in children, accounting for two million A&E department visits each year at a cost of £146m to the NHS.

The authors say it is children from the poorest families who suffer the most, as 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 they believe that the key issue is the lack of political support for surveillance systems, which they say is essential for monitoring childhood injury at country level, despite the UK government prioritising the health and wellbeing of children.

“If the UK government is really committed to the health and wellbeing of children and to ameliorating inequalities then much more is needed,|” the authors write, arguing the government “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”.