RESUMO
In this study we aimed to produce the first detailed analysis of the epidemiology of the severe injury and mortality impacts of the 1931 Hawke's Bay earthquake in New Zealand (NZ). This involved the compilation and analysis of archival data (hospitalisations and deaths) including the examination of 324 death certificates. We found that there were 662 people for whom some hospitalisation data were available at four weeks post-earthquake: 54% were still in hospital, 4% were still classified as "serious", and 5% had died (n = 28). Our classification of death certificate data indicated 256 earthquake-attributable deaths and for another five deaths the earthquake was estimated to have played an indirect role. There were 15 buildings associated with three or more deaths each (accounting for 58% of deaths with a known location). Many of these buildings were multi-storey and involved unreinforced masonry - with some of this falling into the street and killing people there (19% of deaths). In contrast, deaths in homes, which were typically of wood construction and single stories, comprised only 3% of deaths. In conclusion, this earthquake had a relatively high injury impact that appears partly related to the lack of regulations for building construction that would mitigate earthquake-related risk. Such regulations continue to be of relevance for New Zealand and for other countries in earthquake zones.
Assuntos
Traumatismos Abdominais/epidemiologia , Traumatismos Craniocerebrais/epidemiologia , Lesões por Esmagamento/epidemiologia , Fraturas Ósseas/epidemiologia , Lacerações/epidemiologia , Traumatismos Abdominais/história , Traumatismos Abdominais/mortalidade , Adolescente , Adulto , Idoso , Baías , Códigos de Obras/história , Criança , Pré-Escolar , Indústria da Construção/história , Traumatismos Craniocerebrais/história , Traumatismos Craniocerebrais/mortalidade , Lesões por Esmagamento/história , Lesões por Esmagamento/mortalidade , Atestado de Óbito/história , Desastres , Terremotos , Feminino , Fraturas Ósseas/história , Fraturas Ósseas/mortalidade , História do Século XX , Hospitalização/estatística & dados numéricos , Humanos , Lacerações/história , Lacerações/mortalidade , Masculino , Pessoa de Meia-Idade , Nova Zelândia/epidemiologia , Fatores de Risco , Análise de SobrevidaRESUMO
Experience shows that regulatory intervention can lead to substantial improvement in population health. The history of regulatory intervention in public health suggests that 'tipping points' necessary to catalyse regulatory change may be identified. We examine three areas in which governments have legislated to protect public health: sanitation, building standards, and vehicle emissions. We apply the lessons to regulatory reform addressing obesity and the chronic disease it causes.
