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Masao Ichikawa, MPH

At the time of the study, the author was with the Department of Public Health, Juntendo University School of Medicine, Tokyo, Japan.

Correspondence: Correspondence should be sent to Masao Ichikawa, MPH, Department of Community Health, School of International Health, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan (e-mail: masao{at}m.u-tokyo.ac.jp).

	INTRODUCTION

TOP INTRODUCTION References

 
Clark et al. presented interesting findings on injury mortality in East Germany in terms of social changes.¹ In fact, injury mortality trends reflect histories of societies. Here I provide an example from Japan, with an overview of trends in mortality due to unintentional injuries over the past 100 years. Mortality data presented here were derived from governmental statistical records.^2,3

Figure 1 shows mortality due to unintentional injuries, by sex, between 1899 and 1998. Historically, men have been more likely than women to be killed as a result of unintentional injuries. Death rates for both sexes for 1923 and 1995 were exceptionally high owing to significant earthquakes that occurred in those years. It is also noteworthy that there was a sharp decline in mortality in the 1970s followed subsequently by a slight increase in the 1990s.

View larger version (21K): [in this window] [in a new window]   FIGURE 1—— Mortality from unintentional injuries: Japan, 1899–1998.

View larger version (21K): [in this window] [in a new window]   FIGURE 2—— Male mortality from motor vehicle crashes and other unintentional injuries: Japan, 1947–1998.

View larger version (23K): [in this window] [in a new window]   FIGURE 3—— Female mortality from motor vehicle crashes and other unintentional injuries: Japan, 1947–1998.

The relationship between mortality due to motor vehicle crashes, mortality due to other unintentional injuries, and mortality due to all unintentional injuries was similar between males and females. Male mortality consistently exceeded female mortality, but there were exceptions in the case of particular unintentional injuries. For example, in 1959, elevated mortality due to unintentional injuries not stemming from motor vehicle crashes was more prominent in females. The reason is that females were more victimized by natural disasters (typhoons and floods) that occurred in that year.

Increased mortality rates due to motor vehicle crashes were accompanied by an increase in the number of car owners.⁴ However, the mortality rates have dramatically declined since 1970. In that year, the country's first traffic law was put in force, and traffic safety began to be planned and implemented nationwide.⁵ This regulation effectively reduced motor vehicle crashes.

After decreasing constantly over the years as a result of public health efforts, mortality due to non–motor vehicle unintentional injuries began to rise in the 1990s. Examination of this trend by age group showed that mortality due to suffocation, drowning, and falls among older adults had increased in recent years.⁶ This result may be associated with restricted physical functioning in later adulthood; however, other factors, such as living circumstances, could be related as well. For instance, in the past 2 decades, the number of individuals 65 years or older who live alone or only with their spouse has increased 4-fold.⁷ Further investigation is required to confirm such potential effects of social factors on unintentional injuries.

	Footnotes

 
Peer Reviewed

Accepted for publication March 10, 2001.

	References

TOP INTRODUCTION References

 
1. Clark DE, Wildner M, Bergmann KE. Injury mortality in East Germany. Am J Public Health. 2000;90:1761–1764.[Abstract/Free Full Text]

2. Ministry of Health and Welfare. Vital Statistics of Japan. Tokyo, Japan: Japan Statistical Association; 1988–2000.

3. Management and Coordination Agency. Historical Statistics of Japan, Volume 1. Tokyo, Japan: Japan Statistical Association; 1987.

4. Traffic Statistics: 1998/99 [in Japanese]. Tokyo, Japan: National Police Agency; 1999.

5. Ochi T. Changes in traffic management. IATSS Rev. 1994;20(suppl):4–15.

6. Ichikawa M, Marui E. Mortality of unintentional injuries in childhood and later adulthood in Japan: 1968–1997. Jpn J Health Hum Ecol. 2000;66:126–136.

7. Institute of Population Problems. Study on the Model Projecting the Elderly's Living Arrangements: Projection of Living Arrangements of the Elderly in Japan 1990–2010 [in Japanese]. Tokyo, Japan: Ministry of Health and Welfare; 1995.

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