Addressing the socioeconomic safety divide: a policy briefing

Lucie Laflamme, Karolinska Institutet, Stockholm, Sweden
Dinesh Sethi, WHO Regional Office for Europe
Stephanie Burrows, Université de Québec à Montréal, Montréal, Canada
Marie Hasselberg, Karolinska Institutet, Stockholm, Sweden
Francesca Racioppi, WHO Regional Office for Europe
Franklin Apfel, World Health Communication Associates, Somerset, United Kingdom
WHO Regional Office for Europe - Copenhagen, Denmark - 2009

Available online PDF [38p.] at: http://www.euro.who.int/document/e92197.pdf

“…….Injury and violence are a leading cause of death and disability in the WHO European Region. Wealth is a major determinant of health, and there is a steep social gradient of ill health due to injuries and violence. Addressing this important cause of inequity in health is a matter of social justice.

This policy briefing summarizes evidence on the socioeconomic safety divide from a large systematic review: Socioeconomic differences in injury risks.
A review of findings and a discussion of potential countermeasures.

People in low- and middle-income countries and more deprived people in high-income countries are worse off. Social and economic policies affect families’ susceptibility to injury by affecting social and physical environments. This policy briefing summarizes evidence on the socioeconomic safety divide from a large systematic review. It then provides messages for policy-makers, researchers and public health advocates and safety planners on what can be done to address this safety divide. Action for preventing injury and violence needs to be intersectoral.

Governments need to aim for equity across all types of government policies to address the uneven distribution of injuries. Action needs to be taken both to reduce injuries and violence universally in the population using passive interventions to make the social and physical environment inherently safer and to target disadvantaged populations. Addressing this important cause of inequity in health is a matter of social justice….”

CONTENTS
Introduction
Evidence on the socioeconomic safety divide
General findings
Results for specific injuries
Road traffic injuries .
Falls, burns, poisoning, drowning and mixed injuries
Self-directed violence
Interpersonal violence
Area, injury type and economic studies

Addressing the socioeconomic safety divide – messages for policy-makers
Message 1: socioeconomic inequality in violence and injuries is a great problem that can be reduced through action .
Message 2: crafting solutions requires knowing the scale and location of the problem
Message 3: develop and implement equity-oriented policies and interventions
Message 4: make sure safety-for-all strategies are in place
-Legislation, regulation and enforcement Community-based programmes .
Home safety education and home visitation programmes .
Message 5: target the population groups most at risk
Decreasing differential susceptibility
Decreasing the differential consequences of injuries
Decreasing differential exposure
Influencing social stratification

Addressing the socioeconomic safety divide – messages for researchers .
Message 1: enhance the rigour of study design
Message 2: studies are needed in low- and middle-income countries
Message 3: more attention needs to be paid to intervention research and how it can reduce the safety divide

Addressing the socioeconomic safety divide – messages for public health advocates and safety planners
Message 1: frame equity in safety as a major public health problem amenable to policy action – injuries are no accident
Message 2: build intervention strategies on public health principles
Message 3: customize your advocacy and action to the needs of the environments
Message 4: give a voice to vulnerable people
Message 5: catalyse links between researchers and policy-makers

Conclusion .
References .
Annex 1. Methods of the review .