Efecto del desarrollo económico en la mortalidad relacionada con el transporte, entre diferentes tipos de usuarios de las vías: un estudio transversal internacional.

Este artículo presenta un análisis de regresión transversal con datos recientes de mortalidad en 44 países, utilizando datos de certificados de defunción provenientes de la Organización Mundial de la Salud

Efecto del desarrollo económico en la mortalidad relacionada con el transporte, entre diferentes tipos de usuarios de las vías: un estudio transversal internacional

Introducción: La relación entre el estado de desarrollo económico de un país y su tasa de mortalidad por colisiones de vehículos de motor (CVM) no ha sido definida para los diferentes tipos de usuarios de las vías. Métodos: Este artículo presenta un análisis de regresión transversal con datos recientes de mortalidad en 44 países, utilizando datos de certificados de defunción provenientes de la Organización Mundial de la Salud. Resultados: Para cinco tipos de usuarios de las vías, la mortalidad por CVM es expresada como muertes por 100.000 habitantes, y muertes por 1.000 vehículos de motor. El desarrollo económico es medido como el Producto Interno Bruto (PIB) per cápitaen dólares de Estados Unidos, y como vehículos de motor por 1.000 habitantes. Los resultados mostraron que la mortalidad total por CVM en los países con bajos ingresos presentó un pico a un PIB alrededor de US $2.000 per cápita, y cerca de 100 vehículospor 1.000habitantes.Conclusiones: La mortalidad total disminuyó con el incremento del ingreso nacional alrededor de US$24.000. La mayoría de los cambios en la mortalidad por CVM asociados con el desarrollo económico fueron explicados por cambios en las tasas de usuarios nomotorizados, especialmente de peatones. Las tasas totales de CVM fueron más bajas cuando la exposición de los peatones fue menor o porque hubo pocos vehículos de motor o peatones; y fueron más altas durante un periodo crítico de transición hacia transporte motorizado, cuando gran cantidad de peatones y otros usuarios vulnerables compitieron por el uso de las vías con vehículos de motor.AbstractIntroduction: The relationship between a country’s economic development and its fatality rate from motor vehicle accidents (MVA) has not been studied according to the different types of users of public thoroughfares. Methodology: This article presents a cross analysis of recent mortality data from 44 countries through the use of information found in the death certifications supplied by the World Health Organization. Results: For five types of users of public roadways the mortality rate by MVA is presented as deaths per 100,000 inhabitants and deaths per 1000 motor vehicles. Economic development is measured by the per capita GDP (Gross Domestic Product) in US dollars and the number of motor vehicles per 1000 inhabitants. The results showed that the total mortality rate by MVA in low income countries reached a peak at a GDP of around US $2000 per capita and around 100 motor vehicles per 1000 inhabitants. Conclusions: The overall mortality rate diminished with the increase of national incomeat around US$24,000. The majority of the changes in fatality by MVA in association with economic development were explained by changes in the number of nonmotorized users of public ways, especially pedestrians. The total number of MVA was reduced when the exposure of pedestrians to motorized traffic was lower either because there were fewer motor vehicles or because there were fewer pedestrians. The rate was higher during critical periods of transition towards more motorized transportation when many pedestrians and other non-motorized users of public thoroughfares were competing for space with increased numbers of motorized vehicles. Key words: Transit accidents, fatalities, economic developmen

Opioid Analgesic Involvement in Drug Abuse Deaths in American Metropolitan Areas

I measured the role of opioid analgesics in drug abuse–related deaths in a consistent panel of 28 metropolitan areas from the Drug Abuse Warning Network. The number of reports of opioid analgesics increased 96.6% from 1997 to 2002; methadone, oxycodone, and unspecified opioid analgesics accounted for 74.3% of the increase. Oxycodone reports increased 727.8% (from 72 to 596 reports). By 2002, opioid analgesics were noted more frequently than were heroin or cocaine. Dramatic increases in the availability of such opioids have made their abuse a major, growing problem

US data show sharply rising drug‐induced death rates

Substantial numbers of deaths are related to disease and injury resulting from the use of drugs, alcohol and firearms worldwide. Death rates associated with these exposures were compared with those from motor vehicle crashes in the US from 1979 to 2003 by race. Among Caucasians, drug‐induced death rates rose sharply after 1990 and surpassed deaths involving alcohol and firearms in 2001 and 2002, respectively. Among African‐Americans, drug‐induced deaths surpassed alcohol‐induced deaths for the first time in 1999

Vital Signs: Overdoses of Prescription Opioid Pain Relievers - United States, 1999-2008

Background: Overdose deaths involving opioid pain relievers (OPR), also known as opioid analgesics, have increased and now exceed deaths involving heroin and cocaine combined. This report describes the use and abuse of OPR by state. Methods: CDC analyzed rates of fatal OPR overdoses, nonmedical use, sales, and treatment admissions. Results: In 2008, drug overdoses in the United States caused 36,450 deaths. OPR were involved in 14,800 deaths (73.8%) of the 20,044 prescription drug overdose deaths. Death rates varied fivefold by state. States with lower death rates had lower rates of nonmedical use of OPR and OPR sales. During 1999--2008, overdose death rates, sales, and substance abuse treatment admissions related to OPR all increased substantially. Conclusions: The epidemic of overdoses of OPR has continued to worsen. Wide variation among states in the nonmedical use of OPR and overdose rates cannot be explained by underlying demographic differences in state populations but is related to wide variations in OPR prescribing. Implications for Public Health Practice: Health-care providers should only use OPRs in carefully screened and monitored patients when non-OPR treatments are insufficient to manage pain. Insurers and prescription drug monitoring programs can identify and take action to reduce both inappropriate and illegal prescribing. Third-party payers can limit reimbursement in ways that reduce inappropriate prescribing, discourage efforts to obtain OPR from multiple health-care providers, and improve clinical care. Changes in state laws that focus on the prescribing practices of health-care providers might reduce prescription drug abuse and overdoses while still allowing safe and effective pain treatment