Analysis Of Injury And Violence Problems In Kyrgystan

Data Description

Kyrgyzstan is a Central Asian country full of natural beauty, proud of nomadic traditions and maximum territory of its land is formally annexed to the Russian Empire.

In 2015, Kyrgyzstan had total population of 17,625,000 with gross national per capita income of $20 in 2015, which is termed as low per capita income. The life expectancy rate at birth of the country has been 66/75 in 2015, along with the probability of dying ratio between age 15 to 60 years 279/118 per 1000 population in 2015. The overall ratio depicts the low profile of the country along with low expenditure per capita on health by the government of $1068 in 2014. The total expenditure on health is only 4.4% of their GDP in 2014.

In the report, we are analyzing the data of injury and violence.

The dataset used for the report has been divided into four categories. It is divided based on counties, age, gender, year and top death causing issues.

The time-period for the analysis is 5 years, which means that the data is collected with the time interval of 5 years. For both the sexes, the age is divided from 15 years to 70 years. The interval of data is divided as between 1990-1999 with the data code B50 for cause group A, B51 for group B, B52 for group C, B56 for group D.

Group A represents deaths caused by accidental falls, Group B represents deaths due to fires or flames, Group C represents deaths caused by other accidental injuries and Group D represents deaths caused by violence. Cause of Death Query of WHO was used to extract data used on the report. The portal of WHO is web-based system for extracting trend series and detailed causes of mortality.

Country Code	name	Year	List	Icd
4184	Kyrgyzstan	1981	09N	Icd9
4184	Kyrgyzstan	1982	09N	Icd9
4184	Kyrgyzstan	1985	09N	Icd9
4184	Kyrgyzstan	1986	09N	Icd9
4184	Kyrgyzstan	1987	09N	Icd9
4184	Kyrgyzstan	1988	09N	Icd9
4184	Kyrgyzstan	1989	09N	Icd9
4184	Kyrgyzstan	1990	09N	Icd9
4184	Kyrgyzstan	1991	09N	Icd9
4184	Kyrgyzstan	1992	09N	Icd9
4184	Kyrgyzstan	1993	09N	Icd9
4184	Kyrgyzstan	1994	09N	Icd9
4184	Kyrgyzstan	1995	09N	Icd9
4184	Kyrgyzstan	1996	09N	Icd9
4184	Kyrgyzstan	1997	09N	Icd9
4184	Kyrgyzstan	1998	09N	Icd9
4184	Kyrgyzstan	1999	09N	Icd9
4184	Kyrgyzstan	2000	104	Icd10
4184	Kyrgyzstan	2001	104	Icd10
4184	Kyrgyzstan	2002	104	Icd10
4184	Kyrgyzstan	2003	104	Icd10
4184	Kyrgyzstan	2004	104	Icd10
4184	Kyrgyzstan	2005	104	Icd10
4184	Kyrgyzstan	2006	104	Icd10
4184	Kyrgyzstan	2007	104	Icd10
4184	Kyrgyzstan	2008	104	Icd10
4184	Kyrgyzstan	2009	104	Icd10
4184	Kyrgyzstan	2010	104	Icd10
4184	Kyrgyzstan	2011	104	Icd10
4184	Kyrgyzstan	2012	104	Icd10
4184	Kyrgyzstan	2013	104	Icd10
4184	Kyrgyzstan	2014	104	Icd10
4184	Kyrgyzstan	2015	104	Icd10

Injuries are caused by different reasons

1. Road traffic crashes.(Due to speeding, drinking and driving, no use of motorcycle helmets, no use of seat-belts, due to child restraints, unsafe roadway infrastructure, vehicle and safety equipment standards, not using daylights for motorcycles, not having licensing system for motorcycles).
2. (Due to smoking, temperature of water, burn centre).
3. Drowning. (Unsafe water of child care, unsafe rescue skills, unsafe rescue and resuscitation, scarcity of flotation device).
4. (Absence of window guards of tall building, low-level standard of furniture and playground equipment).
5.  (Unsafe use of medicines and drugs, lethal quantities of drugs, scarcity of poison-control centers).
6. (Unsafe and unstable relationship between children and their guardian, life skill in children and adolescents, harmful use of alcohol, access to guns and knives, gender inequality and violence against women, violence due to cultural and social norms, violence through victim identification, care and support prigrammes).
7. (By firearms, pesticides and certain medications, harmful use of alcohol, presence of mental disorders and frustration).

Here, we are eager to analyze the data of different levels of injury and death due to violence that are shown in the below pyramid.

Deaths due to violence has occurred due to sharp force (35%) followed by Unknown source (31%). Blunt force (14%) and other (10%) sources are the significant reason of death due to violence.

The line diagram indicates that frequency of homicide is maximum (7.3 per 100000 population) in 2005 in Kyrgyzstan.

The graph indicates that passengers (all vehicle) and pedestrians die due to injury in maximum. In 2007, the deaths due to traffic injury (24 per 100,000 population) was maximum in Kyrgyzstan according to the line diagram.

	Year 1999		Year 1995			Year 1990
	Male	Female	Male	Female		Male	Female
A	50	7	238	69		138	33
D	324	73	45	16		14	1
B	16	9	40	9		55	10
	390	89	323	94		207	44
Total	479		417			251

Table1: Cause of death codes classified as a death due to injury or violence.

The total death due to violence is growing day by day from 1990 to 1995. The year wise cases of total violence is accounted as 1990 (479), 1995 (417), 1990 (251). Especially deaths caused by violence of males in 1999 (324) has become significant. It is also a notable fact that death due to accidental falls and deaths due to accidents by fire and flames has decreased year after year. However, surprisingly, deaths due to violence have rapidly increased from year 1990 to 1999. Not only that, deaths due to violence for females in 1990 was insignificant in 1990 (1). The number has arisen to 73 for females in 1999.

Causes of Death in the Data

The TOT has caused maximum of the death and contributed 50% of the total death reasons. The death causes are followed as others (31.40%), I251 (11.80%), Heart and Mediastinum (I64) (3.20%), k746 (2.20%), 1259(1.40%). TOT is the equal of all reasons for deaths taken together.

2015		2000		1985
Disease Code	Death RATES	Disease Code	Death RATES	Disease Code	Death RATES
TOT	34809	TOT	34113	B00	32332
I251	8196	I251	5785	CH07	12037
I64	2266	I64	2414	CH08	8663
K746	1561	J448	1503	B27	6436
I259	792	K746	1111	B279	5525
I219	771	I672	1056	B29	4630
J448	704	R54	1034	B321	3176
I250	661	J180	1019	CH02	3040
R99	643	I219	811	S08	2998
P011	504	A162	757	CH17	2741
C169	462	I619	604	S329	2342
I619	418	I259	457	CH01	2136
I110	390	I678	439	S47	1882
I672	374	X700	398	S310	1736
I639	367	C169	370	CH09	1211
I630	361	I110	344	B01	1193
X700	351	I639	312	S019	1186
J180	297	J439	311	B323	966
C349	282	A09	303	B270	911
V031	277	I618	296	S347	813
TOTAL	54486		53437		95954

Table3: Cause of death codes classified as a death due to diseases for 1985-2015.

From the table we observe that TOT is the major reason behind the disease. I251 is the following reason behind death rate. 8196 people have died due to it in 2015. I64 is also a significant rate of death though the death rate is decreasing day by day.CH07 (Diseases of the Circulatory System) (frequency =12037) and CH08 (Diseases of the Respiratory System) (frequency=8663) were the major reasons of dying in 1985. Surprisingly, B00 (All Causes) was the major reason was dying in 1985 with maximum count 32332.

The disease S347 (frequency=813) was the most insignificant reason behind the death in 1985. I618 (frequency=296) was the most minor reason in the year 2000. External causes of injury (V031) are the minor reason behind death in 2015. K746 is also a prominent reason of dying in the years 2000 and 2015. We observe that reasons behind diseases in 2015 and 2000 are similar in many cases. However, the reasons of disease in 1985 were different from next two scenarios. Total deaths due to diseases (95954) were highest in 1985. Therefore, total deaths due to disease decreased in 2000 (53437) and 2015 (54486).

The important issue to observe that TOT has risen to be major reason of death after 1995. However, the cause was not prominent at 1995. I251 is another major cause of disease that has grown linearly year by year from 1985 to 2015. Disease I64 was not the significant reason of death in 1985 but became in 2000. The frequency is downwards again in 2015. I259, J448 is also increasing gradually in 30 years.

It could be said, that the death rates have increased over the past thirty years; such thing has happened due to limited access to the resources and inadequate healthcare facilities.

AGE GROUP (15-19)		AGE  GROUP (20-24 )		AGE GROUP (25-29)
TOT	316	TOT	510	TOT	683
X700	48	R99	44	R99	51
R99	26	X700	42	V031	35
V031	10	V031	27	X700	28
K746	9	V899	21	K746	26
TOTAL	409	TOTAL	644	TOTAL	823

Table4: Cause of death codes classified as a death due to diseases for age group 15 to 29 in 1985-2015.

The age group is an important factor of deaths during the years. The age group (25-29) has high frequency 823 and age group (15-19) has lowest frequency 409. The TOT is the main reason of injury in all the age groups. The role of cause X700 (Other diseases of skin and subcutaneous tissue) is increasing in increasing age-groups. The reason K746 is lowest in the Age group (25-29) and (15-19). However, K746 did not have effect in the age group (20-24).

From the above-analyzed graph, it could be seen that the most vulnerable age group is from Age 25-29 years. The least vulnerable age group is 15-19 years. We have observed an increasing linear trend line of deaths of increasing group wise column plot.

The next question is,

Data Analysis

Does poverty increase the risk of injury?

We need calculate the comparative analysis and graphical representation of levels of injury due to violence between two different countries of different economic level. Kyrgyzstan is a country whose WHO region code is Eur LMI and Denmark is a country whose region code is Eur HI. We compare the injury level of these two countries.

The chart is a comparison of poverty level of Denmark and Kyrgyzstan of the same WHO country code but on different per capita. As indicated Denmark’s trend seem to be rather stable over a period of more than decade whereas Kyrgyzstan’s increases. Hence, more mortality because of violence and injury in Kyrgyzstan has observed than Denmark. In 2015, the increase percentage has become almost 80% in 2015 from under 60% in 1955. Denmark that is a country of higher economic level has increased its percentage of injury from about 88% (1955) to 98% (2015).

The rate of increase of Denmark of injury is low and stable. The rate of increase of Kyrgyzstan is negative in 1955 to 1965, but the increase rate is very high in 1990 and 2015.

Injuries and violence cause considerable economic losses to victims and their families of Kyrgyzstan. Losses arise from the cost of treatment including rehabilitation and incident investigation as well as reduced productivity.  Despite growing awareness of the magnitude of the problem, attention to injury and violence prevention and control among policy-makers and those funding global public health programming remains disproportionately low. Deaths related injury and violence is growing rapidly.

The violence results mainly physical injuries as well as mental consequences, behavioral changes and chronic diseases. These lead to death, disability or cardio-vascular diseases.

The alarming cause of death is violence. The broad range of strategies based on sound scientific evidence that have been shown to be effective and cost-effective at reducing injuries and violence. These strategies needed to be more implemented.

In recent decades (30 years), the significant slow increase in injuries has been arisen in high-income country named Denmark. Their restricted burden of injury considerably occurred due to proven prevention and treatment strategies. However, despite the fact that progress has been made, both the countries must increase their investment in injury prevention. The steps are implementation, Intervention development, Risk Factor identification and Surveillance.

Conclusion:

Providing quality support and care services to victims of violence and injuries could prevent fatalities. It could reduce the amount of short-term and long-term disability. Improving the organization, strategy, planning and access to trauma care systems includes pre-hospital and hospital-based care to reduce the effect of injuries. Providing rehabilitation for people with disabilities and removing obstacles to ensure that people who experience disability as the result of an injury may continue a full and enjoyable life.

Heath-Brown, N., 2015. Kyrgyzstan. The Statesman’s Yearbook 2016: The Politics, Cultures and Economies of the World, pp.738-741.

Wilkinson, C., 2015. Imagining Kyrgyzstan’s nationhood and statehood: reactions to the 2010 Osh violence. Nationalities Papers, 43(3), pp.417-436.

Melvin, N., 2011. Promoting a stable and multiethnic Kyrgyzstan: overcoming the causes and legacies of violence (pp. 1-64). New York: Open Society Foundations.

Kyrgyzstan Inquiry Commission, 2011. Report of the Independent International Commission of Inquiry into the events in Southern Kyrgyzstan in June 2010. Kyrgyzstan Inquiry Commission.