Large urban–rural disparity in the severity of two-week illness: updated results based on the first health service survey of Hunan Province, China

BACKGROUND: To examine urban–rural differences in the severity of non-fatal disease and injury using the latest household interview survey data of Hunan Province, China. METHODS: Two-week illness data were from the first provincial health household interview survey of Hunan in 2013. The proportion of patients being bedridden, the average days of being bedridden and the average off-work days were calculated to measure the severity of two-week illness. Rao-Scott-adjusted chi-square test was performed to examine the significance of two-week illness severity differences from demographic variables. Multiple logistic regression and linear regression were used to control for sex, age and household income. RESULTS: The two-week illness prevalence was 22.8 % in Hunan province. Despite similar two-week ill prevalence rates between urban areas and rural areas (23.0 % vs. 22.8 %), rural residents had higher proportions of being bedridden and of being off work than urban residents after controlling for sex, age and household income, with adjusted odds ratios of 3.4 and 6.9, respectively. Similarly, the average days of being bedridden and of being off work in rural residents were 0.45 days and 1.61 days longer than in urban residents after controlling for demographic variables, respectively. CONCLUSION: The recent data shows that two-week illness in rural residents is more serious than urban residents in Hunan Province, China in spite of very similar two-week prevalence rates. The neglected urban–rural disparities in the severity of two-week illness deserve the attention of health policy-makers and researchers

Evaluating the Effectiveness of Implementing a More Severe Drunk-Driving Law in China: Findings from Two Open Access Data Sources

In 2011, China implemented a more severe drunk-driving law. This study evaluated the effectiveness of the law on road traffic morbidity and mortality attributed to alcohol use. Data were from two open-access data sources, the Global Burden of Disease (GBD) 2015 update and police data. Poisson regression examined the significance of changes in morbidity and mortality. Large gaps in crude death estimates from road traffic crashes attributed to alcohol use emerged between the two data sources. For the GBD 2015 update, crude and age-standardized mortality displayed consistent trends between 1990 and 2015; age-standardized mortality per 100,000 persons increased from 5.71 in 1990 to 7.48 in 2005 and then continuously decreased down to 5.94 in 2015. Police data showed a decrease for crude mortality per 100,000 persons from 0.29 in 2006 to 0.15 in 2010 and then an increase to 0.19 in 2015. We conclude available data are inadequate to determine the effectiveness of the implementation of the more severe drunk-driving law in China since the two data sources present highly inconsistent results. Further effort is needed to tackle data inconsistencies and obtain reliable and accurate data on road traffic injury attributable to alcohol use in China

Conflicts between bus drivers and passengers in Changsha, China

Bus safety represents an important topic for injury prevention. When drivers experience conflict with their passengers, it likely distracts them from the driving task, both physically and mentally, and jeopardizes the safety of all passengers. However, detailed information concerning the frequency and type of conflicts between bus drivers and passengers is unavailable. We conducted a driver-reported cross-sectional survey to investigate the characteristics of driver-passenger conflict in the past month. The survey was completed in Changsha city, China in August 2019. In total, 779 bus drivers were surveyed. Of 732 drivers who completed the questionnaire, 635 (86.7%; 95% confidence interval: 84.3–89.1%) drivers reported experiencing at least one conflict with passengers in the past month. After adjusting for other demographic variables, drivers who were male, younger, less educated, less experienced as a bus driver, and with a comparatively high self-reported work intensity were more likely to report experiencing conflicts. Of the reported conflicts, verbal quarrels and abuses were most common, followed by “passengers attacked driver with physical objects like sticks or knives” and “passengers spat on or threw objects toward the driver”. Most drivers reported that they had experienced only conflicts causing no physical injury or financial loss in the past month, but a small portion experienced conflicts causing injuries to themselves. The most frequent reasons for driver-passenger conflicts were “passenger refused to pay fare”, “passenger requested to get off the bus at a location that was not a bus stop”, and “passenger was drunk or deliriously attacked the driver”. Bus drivers responded to some of the passengers’ verbal or physical attacks, but not all. Some preventive measures were adopted frequently by bus companies (e.g., bus alarms, protective shields for drivers) but others were not. Least often adopted were efforts to offer safety training for drivers (46.6%) and to offer psychological counseling services for drivers (39.1%). We conclude that bus driver-passenger conflicts are common in Changsha city, China. The conflicts impose a substantial threat to the safety of both drivers and passengers. We recommend multiple preventive actions to reduce driver-passenger conflicts and improve bus safety