Grim Reaper kept busy by ignorance and negligence

Photo: Riigikantselei

As compared to rest of Europe, Estonia loses way too many lives due to injuries. Having studied the causes, Government Office strategy bureau adviser Maris Leimann says the state should deal with changing people’s attitudes – thus, many deaths would not be.

Why so many injury-deaths in Estonia, as compared to rest of Europe?

Probably, the main reasons vary. No denying, alcohol is a major risk factor. With suicides in 2013, 40 percent were drunk. Regarding those that died in fires, the percentage was 69. At the same time, Estonia has had a very liberal alcohol policy.

To avoid injuries, raising awareness is vital. Not too long ago, safety belts buckled in cars was rather the exception.

Probably, we need to try hard to alter attitudes in people. Lots of deaths could be avoided if others would stop drunken ones to take the wheel, go swimming... would not pass by the sleeper on park bench on a cold night.

Not long ago, this small kindergarten age boy was running around in a shopping mall parking lot. None took notice but me. With many people around, why did they not think to help?

While there’s always a male/female difference, this is remarkably so in Estonia. Why so many Estonian guys dead through injuries?

The guys do risk more. That’s from the boys and up. And not in Estonia only. Still, Estonia has the vast gap – and it’s due to alcohol. Risk and alcohol are a bad combination.

One reason may be that risk groups have not been focussed on enough. With suicides, for instance, the main risk group is men in their 50ies (added factors being unemployment and alcohol). The same group with alcohol poisonings. With drugs poisonings, however, the risk group is men in their 30ies.

Here, treatment of alcoholism is shown as vital. That would help avoid dropping out of labour market or help one make his comeback; thereby, suicides could be prevented.

How much, realistically, could deaths by injuries be reduced? What would that take?

There’s no reason Estonia could not be below EU average, at least. That means cutting deaths by injuries by half. With 958 perished in 2013 out of injuries, we could thus save a minimum of 500 lives a year.

In 2013, deaths by injuries were most prevalent among those aged 50–59. A lot of working age people become incapable due to injuries – in 2013, initial permanent incapacity for work was diagnosed for 1,300.

What kinds of deaths would be likeliest to cut near-term, and which would take longer?

The three leading deaths by injury are poisonings, suicides and falls. The poisonings are mostly of alcohol and drugs. Systematic alcoholism treatment might help. For drug addicts, we do have the treatment but specialists say on too low a scale.

We definitely need to deal with suicides. Ten years ago, the risk factors were found to be being male, unemployed, and alcohol problems. Regrettably, we have no fresh data.

When it comes to falling, it is difficult to take a stand as we have no data. A risk factor, again, is alcohol – in 2013, post mortem revealed 37 as intoxicated of those who fell to their death. Meanwhile, for instance, we do not know the percentage of neglect with safety measures on building sites, for instance.

As compared to 1990ies, traffic deaths have rapidly shrunk. Here, the key has been Road Administration and Police and Border Guard Board cooperation: preventive activities and campaigns are linked to surveillance and monitoring.

With fire deaths, Rescue Board alone can’t help. Studies show a vital risk is social problems. Thus, the time factor is difficult to predict.

As one responsible for shaping health policy, I’d not focus on deaths alone, though. When it comes to falls, most abundant as causes of injuries, science-based methods exist to help improve the situation. 

Most of injuries with children happen in home environment and, to curb these, we’d need to raise awareness of parents. Important for people to make home environment as safe as possible. Same with falls of the elderly.

Often, they fall on a level surface, like stumbling at the edge of a carpet. Comical as this may seem, it may lead to serious injuries, and – due to age-related peculiarities – the treatment is long-term and costly.