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Johns Hopkins International Injury Research Unit

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JH-IIRU Leadership to Participate in Global Launch of New Project with USAID

Johns Hopkins International Injury Research Unit Director Dr. Abdul Bacani and leaders in the field of rehabilitation and health systems will participate in a global launch of Learning, Acting, and Building for Rehabilitation in Health Systems (ReLAB-HS) on Wednesday, February 24 at 8 a.m.

In the virtual event, Dr. Bachani and panelists from both the World Health Organization and United States Agency for International Development will introduce the consortium and highlight the need for integrating rehabilitation within health systems to achieve the sustainable development goals and universal health coverage.

The launch will introduce the consortium's comprehensive goals, as well as its implementation strategies to address the need for rehabilitation responsive health systems.

To register for the virtual event, please click here

For more information about ReLAB-HS, click here.

Building Back Better with International Day of Disabled Persons 2020

Today is the annual observance of the International Day of Disabled Persons, proclaimed by the United Nations first in 1992 to promote an understanding of disability issues and mobilize support for the dignity rights, and well-being of persons with disabilities.

Disability is truly a global issue and about 15% of the world’s population—more than one billion people—live with some form of disability, according to the World Health Organization.

The team at Johns Hopkins International Injury Research Unit, including faculty, students, and staff, not only recognize this day of observance and the toll disability takes on so many people around the world, but work day in and day out to address and counter this global burden.

We know from our work and that of colleagues around the world, that disability not only affects the individual, but also has consequences (health, social, and economic) for family members, friends, and the community. In collaboration with partners in Cambodia, Kenya, Malaysia, and Vietnam, our team has worked to understand the long-term health, social and economic impact of disability on individuals, their caregivers, and families. Using a holistic sociological framework to account for the interrelatedness of family structures and economic opportunities, we sought to get insight on the impact of disability, as well as various adaptation and coping strategies employed by individuals and their families.

One limitation to addressing this issue is the lack of timely and reliable data to understand the needs of individuals with disability and the barriers they face in accessing services – health and other services for day-to-day functioning. Our work in collaboration with partners in Uganda focused on adapting and implementing standardized disability assessment tools at the community level to better measure disability as an outcome in children and adults. It has provided evidence on the magnitude of the problem and its health and socio-economic impacts. This body of work focuses on approaches for generating data that can be used for policy and decision-making to better understand and address the needs of individuals with disabilities.

Through research, education, and practice, we’re working to contribute to a world inclusive of individuals with disabilities addressing key issues related to diversity and equity.

As we all strive on a global level to stay safe in the world of COVID-19 and support experts in their work to end this pandemic, we especially embrace this year’s International Day of Persons with Disabilities theme, “Building Back Better: toward a disability-inclusive, accessible and sustainable post COVID-19 World.”

For more information and resources on disability and International Day of Disabled Persons, please see the list below:

· International Day of Persons with Disabilities
· International Day of Persons with Disabilities 2020
· Commemorative Event for IDPD 2020: Action Toward a Disability-Inclusive, Accessible and Sustainable Post-COVID-19 World
· United Nations Disability Inclusion Strategy
· Convention on the Rights of Persons with Disabilities
· World Health Organization Overview of Disability
· World Health Organization Fact Sheets on Disability and health
· World Health Organization Disability Facts in Pictures

COVID-19 Lockdown Led to Relative Increase in Speed-Related Traffic Violations and Fatal Crashes in Japan

As a result of COVID-19, government-implemented lockdowns led to a relative increase in speed-related traffic law violations and fatal motor vehicle collisions in Japan, according to research at the Johns Hopkins International Injury Research Unit.

Using police-reported data on the number of fatal motor vehicle collisions between January 2010 and February 2020, researchers forecasted the number of fatal collisions per day from March to May 2020, when Japan was under COVID-19 lockdown. Over the 10 years of data analysis in the country of more than 120 million people, the team reviewed 37,000 fatal collisions.

“Through this work, we can conclude that drivers who continued to drive during the lockdown were in fact more likely to commit speed-related violations that cause fatal motor vehicle collisions than the overall drivers did before the lockdown,” said study lead author Haruhiko Inada. “It is necessary for road users and law enforcement to understand that drivers who remain on the road during a lockdown can be at an increased risk for committing such violations that result in fatal motor vehicle collisions.”

The findings, published online on October 16 in Injury Prevention, could build upon the growing conversation on the pandemic’s effect on global public health, specifically road safety.

“COVID-19 lockdown and fatal motor vehicle collisions due to speed-related traffic violations in Japan: a time-series study” was written by Haruhiko Inada, Lamisa Ashraf, and Sachalee Campbell.

To learn more about the research, please click here.

Responding to the Increasing Need for Global Suicide Prevention

The COVID-19-induced lockdown and restricted lifestyle that followed have heightened our sense of loneliness, fear, depression, and anxiety. Research over the past few months in the United States and other high-income countries have corroborated this phenomenon–increased stress and physiological distress have grappled a large proportion of the population.

Earlier this month, World Suicide Prevention Day focused on acknowledging the ways in which COVID-19 has increased the need for accessible mental health care. The pandemic has created a new sense of urgency to engage communities in finding sustainable solutions for accessing quality mental health care that will help individuals struggling with mental health issues and can prevent suicides.

Suicide is preventable but it’s also a complex and multi-faceted issue, and accounts for more than 800,000 lives lost across the world every year. For more than a decade, suicide has consistently been the second leading cause of death for adolescents and adults 15 to 29 years of age; the numbers continue to rise. Further alarmingly, teen and adolescent suicides increased in the U.S. by 56% in the past two decades. However, it is important to acknowledge that suicide disproportionality affects low- and middle-income countries (LMICs). In 2016 for instance, 79% of all suicides occurred in LMICs. What is more concerning is that a prior suicide attempt is the most common risk factor for suicide, and for every individual who dies by suicide, there are at least 20 more suicide attempts.

Research has shown that suicide does not discriminate by gender, race, or socio-economic status. Mental and behavioral disorders, alcohol and substance abuse, and chronic pain are among other main risk factors associated with suicide. Economic and financial crises or difficulties can also lead individuals to develop mental and behavioral problems due to feelings of uncertainty and increased stress. More recently, the COVID-19 pandemic — combined with systemic problems such as racism, poverty, discrimination, and oppression — has created a unique and overwhelming combination of risk factors to suicide.

The increase in suicide rates intensifies in part due to health systems deficiencies such as lack of accessible resources in the form of counseling, mental health services, and treatment and in part due to societal and communal issues such as stigmatization, inappropriate media coverage, and stressors that come with certain cultures. Access to treatment and supportive, safe spaces for sharing are not available for adolescents in many settings, creating a challenge to drive change in how suicide and related circumstances are viewed. These barriers also affect other vulnerable populations such as the elderly, females, individuals with mental disorders, disabled people, ethnic and indigenous groups, migrants, and refugees disproportionately making them more susceptible to suicide.

Globally, three times as many males die of suicide compared to women, however, this gap is much lower or even inverse in LMICs, and research has shown substantial variations across regions and countries. Cultural and social norms, pre-established gender roles, financial disparities, and domestic violence are potential drivers of this gender association in low resource settings.

Organizations in the United States, such as the Center for Disease Control and Prevention and National Institute for Mental Health, have developed overarching prevention strategies for suicide that range from strengthening economic support, access and delivery of care, creating safe and protective environments, promoting connectedness, teaching coping and problem-solving skills, identifying and supporting people at risk, and reducing harm and preventing future risk. As recent research has highlighted, the prevalence of suicidal ideation and suicide-associated risk factors of depression, anxiety, stress, and mental disorders at much younger ages, identification of such risk factors, and subsequent treatment, as well as prevention are key to shifting the ever-increasing paradigm of suicide amongst children. Additionally, policies have been put in place to limit access to pesticides, drugs and medications and have shown reduction in suicide rates in some countries.

Yet, around the world, many LMICs lack the appropriate foundation of evidence-based systems to address suicide. Many of these programs can be implemented across various groups within the community, such as students, teachers, counselors, parents, and peers, and across different work settings – helping to build a cadre of “first responders” who could identify individuals at risk and avail necessary services. Raising community awareness and providing adequate data on suicide across the globe are essential in breaking down the barriers individuals encounter when deciding whether or not to seek mental health care in their community. Education about risk factors and warning signs of suicide and suicidal ideation requires a coordinated and comprehensive public health approach. With a clear unmet need for treatment in LMICs, there is an opportunity to model the existing prevention strategies into regionally and culturally appropriate prevention tactics applicable to these settings.

More recently, the World Health Organization (WHO) implemented its Special Initiative for Mental Health (2019-2023), dedicated to ensuring access to quality and affordable care for mental health conditions with a goal of reaching 100 million people. WHO intends to advance mental health policies, advocacy, and human rights through evidence-based interventions, and is aimed at providing quality mental health services through community-based and general health and specialist settings. Additionally, promoting mental health and well-being is a part of one of the Sustainable Development Goals, targeted to be achieved by 2030.

Perhaps now, more than ever, it’s critical that we acknowledge the need and urgency for suicide prevention interventions at the global level and work tirelessly to reduce the suffering by those affected. The Johns Hopkins International Injury Research Unit family of faculty, staff, and students know and recognize the tragic reach caused by suicide around the world and encourage all to ask what can we collectively do to prevent suicide?”

One initiative to help counter this gap is the Adolescent Violence and Injury Detection System (AVID), an innovative research project set up in India and Vietnam to develop and implement a community-based system for early detection of adolescents at risk and link them to appropriate service providers, as well as avail support. Through proven, evidence-based measures, we see a path to lives saved and families changed for the better.

If you are in the U.S. and you or someone you know is struggling, please call the National Suicide Prevention Lifeline at 1-800-273-8255 or visit www. Suicidepreventionlifeline.org for more information.

This blog post was co-authored by Johns Hopkins International Injury Research Unit Director Dr. Abdul Bachani, Research Associates Drs. Priyanka Agrawal and Lamisa Ashraf, and Program Coordinator Abigail Green. 

Study Finds Enforcement Efforts Effective in Increasing Correct Motorcycle Helmet Use in Colombia

The presence of enforcement increases the correct use of motorcycle helmets, according to a study led by researchers at the Johns Hopkins International Injury Research Unit and Grupo SUR at Universidad de los Andes.

Semiannual observational studies of motorcycle users in six randomly selected sites in Bogota were conducted between 2015 and 2018. In observing more than 70,000 motorcycles, researchers found that enforcement, increases the correct use of helmets especially in principal roads.

“Our work emphasizes the direct relationship between enforcement and correct helmet use among motorcyclists,” said lead author Luis A. Guzman of Universidad de los Andes. “And it is critically important to understand how we can better protect our motorcyclists and encourage correct helmet use. Here in Colombia the number of motorcyclists has nearly doubled between 2013 and 2018.”

The findings, published online August 21 in Traffic Injury Prevention, could help inform decision makers all across the globe and particularly in low- and middle-income countries where evidence-based road safety interventions are most needed.

In the work, researchers also found that though 99% of drivers and passengers wore helmets, only 89% of drivers and 82% of passengers used them correctly. Female, adult, and single riders were are all more likely to correctly wear helmets. The study also noted a relationship between the concentration of fatalities and incorrect helmet use in 80% of the observational sites.

“The relationships between correct helmet use, enforcement presence, and mortality in a Latin-America city: The case study of Bogota, Colombia” was written by Luis A. Guzman, Andres Ignacio Vecino Ortiz, Vanessa Guzman Mesa, Jose Pablo Camargo, Katharine A. Allen, and Adnan A. Hyder.

To learn more about the research, please click here.