Good morning. Thank you, Madam Chair.
I want to thank this committee for the opportunity to speak, and to acknowledge this important examination into injury prevention.
The work of this committee constitutes a critical step to improving our ability to reduce rates of injury and to improving the health of our population.
I will provide a very brief overview of the size and scope of injuries in Canada, add context about who is involved in addressing this issue, and then describe how the Public Health Agency is contributing to the efforts of reducing injuries among Canadians.
Injury has been defined as damage to the body caused by the sudden transfer of energy that is beyond the body's resilience. That's a fairly unhelpful definition, if I may say so. I think most of us know what we mean here. Injuries may be intentional or unintentional. Unintentional injuries are caused by events such as motor vehicle collisions, falls, drowning, and poisoning. Intentional injuries are caused by violence, such as violence against children and women, and self-inflicted harm, sometimes leading to suicide.
They happen to Canadians in every setting: at home, at the arena, and at work. Many of these injuries are preventable. Injuries are an important health problem in Canada. They are the leading cause of death for Canadians between the ages of one and 44. This is for both unintentional and intentional causes. For every death there are 16 hospital admissions, and too many of these result in impairments and disabilities, such as blindness, spinal cord injury, and intellectual deficit due to brain injury. Unintentional injuries are responsible for the majority of these injuries.
Motor vehicle crashes are the leading cause of injury deaths for most age groups. However, in older adolescents and in youth, suicide ranks first. Interpersonal and family violence is also of concern. Finally, falls are the leading cause of non-fatal injuries, and they are especially frequent among older Canadians.
In addition to causing human suffering, injuries impose a large economic burden. A recent study by SMARTRISK, based on 2004 data, estimated that the total economic burden of unintentional injuries in Canada for all ages is $19.8 billion per year. This figure includes $10.7 billion in direct health care costs and $9.1 billion in indirect costs, including lost productivity due to premature death and disabilities.
Injuries affect health care utilization in other ways. Injuries contribute to crowded hospital emergency rooms. Emergency surgeries for serious trauma cases contribute to wait times for elective procedures. Injuries resulting in long-term impairments and disabilities impact workforce participation and overall productivity.
I would like to take you behind some of these statistics to discuss those most at risk. For infants up to one year, suffocation is most often the cause of injury death. Injuries of various natures continue to be the leading cause of death for children, teens, youths, and adults up to age 44. In 2005, three Canadian children died from injuries every day, for a total of more than 1,081 deaths each year, and over 34,000 children were admitted to hospital.
Motor vehicle collisions, falls, drowning, and poisoning are the leading causes of unintentional injury for children and youth. Most injuries to infants and young children happen at home. For older children and adolescents, many injuries are related to sports and recreational activities. Workplace injuries start to occur among older adolescents and youth as they enter the workforce.
For older adults, falls are an increasingly serious risk. In fact, a third of all seniors experience a fall every year, and falls account for more than half of all injuries among Canadians aged 65 years and over. Many factors contribute to these falls: from biological factors such as visual impairments and balance problems to environmental factors such as ice and snow as well as hazards in the home.
The data also show that Canadians living in northern communities, aboriginal individuals, and families of lower socio-economic status are most likely to suffer injuries. Unintentional injury rates are three to four times higher for aboriginal children than for other children in Canada. Suicide among youth is very high in first nations communities, with rates five to seven times higher than for non-aboriginal youth. Suicide rates among Inuit youth are eleven times the national average. These statistics are particularly troubling when we consider that more than half their population is under 25 years of age.
But injuries are preventable, and I am pleased to say that over the last few decades, injury death rates have been reduced dramatically—40% since 1980. Much of this impressive decline is due to reductions in fatalities caused by motor vehicle crashes. This is good news, and we are seeking to reduce other types of injuries in Canada by applying the lessons we learned from the success of our road safety efforts.
In a 2001 UNICEF Report on Canada, our country ranked 18th out of the 26 OECD countries that reported child injury death rates. We should turn to the leaders in the international community in order to learn about the best practices that have contributed to their low injury rates.
We already know much about many interventions that have been proven to work and are cost-effective. For example, reducing the speed of traffic in some circumstances can reduce the frequency of motor vehicle collisions. Wearing seat belts reduces the risk of injury for those collisions that do occur. I have two other examples drawn from the United States. Every dollar invested in installing and maintaining residential smoke alarms provides overall savings estimated at $65. Every dollar spent on child restraints and bicycle helmets can save nearly $30.
We must also, however, anticipate the challenges that face us in coming years. For example, by 2031, as baby boomers age, older adults will account for almost a quarter of the population, and direct health care costs for fall-related injuries in this population are projected at $4.4 billion. This is more than double the $2 billion cost of these falls in 2004, when only 13% of the population was older than 65.
What are we doing about this at the Public Health Agency?
First, let's recognize that injury prevention is not just a health issue. Preventing injury is a responsibility for many in different sectors, in numerous federal departments, and in all levels of government. I'll name just a few examples of federal actors outside the health portfolio: Transport Canada, with a key role in road safety; the National Research Council, which sets building codes and safety standards; and Labour Canada, which plays an important part in workplace safety. Provinces and territories are heavily engaged on many fronts, and several provinces and territorial governments have adopted injury reduction strategies in recent years.
There are also many non-governmental organizations engaged in injury prevention. Some, like Safe Kids Canada, represented here today, are fully dedicated to the issue. Others, like the Canadian Agricultural Safety Association, focus on specific areas of injury prevention. And still others, like the Canadian Red Cross and the Canadian Pediatric Society, include safety and injury prevention as one of the elements in their mandate.
How does the Public Health Agency fit in?
We see ourselves as an agent of change. We have access to a multi-faceted approach to surveillance and data collection, knowledge development and dissemination, as well as collaboration and coordination. I will explain each of these in detail.
Surveillance is the ongoing, systematic use of routinely collected health data to inform and guide timely public health action. The Public Health Agency of Canada uses data from a variety of sources to profile injuries. In addition, we gather data from two of our own programs: the Canadian incidence study of reported child abuse and neglect, and the Canadian hospitals injury reporting and prevention program, a computerized information system that collects and analyzes data on injuries to people, mainly children, who are seen at emergency rooms in eleven pediatric hospitals and four general hospitals in Canada.
The agency acts as a centre of expertise for knowledge development and dissemination on certain issues, and we develop and disseminate this knowledge to a wide range of audiences, from professionals and policy-makers to individual Canadians. For example, our Division of Aging and Seniors provides advice and support for policy development and conducts and supports research and education activities to reduce the number and severity of falls.
The agency provides support to and participates in the Public Health Network, of which I'm sure you've heard before from Dr. Butler-Jones; it is the network established by federal, provincial, and territorial governments following SARS to be a vehicle for different levels of government and experts to work together to improve public health. We have under PHN an expert group on chronic disease and injury prevention, which does a great deal of work in building the knowledge base, facilitating prevention efforts, strengthening capacity, and monitoring and evaluating.
Along with the work being done by the FPT bodies, the Public Health Agency of Canada plays a role in convening stakeholders from outside the government.
For example, in 2009, the Public Health Agency of Canada co-hosted an Injury Prevention Stakeholder Workshop, which was attended by 50 high-level leaders representing various levels of government and other sectors. The workshop resulted in the creation of a series of recommendations on how all parties could work together on collective efforts.
Thank you.
We would be pleased to respond to your questions.
