Note: New expanded commentary and discussion are here.

Last week the Johns Hopkins University Bloomberg School of Public Health published a study based on data in the 2008 National Health Services Survey of China, which found that falls in the home are the leading cause of injury among elderly in China.

The findings in of themselves are not the kind of thing that will make the front page of a major newspaper, but the study is an example of quite a remarkable trend.

To wit, China’s demographic data was simply not complete enough a decade ago to lend researchers the opportunity to discover trends as minute as how and where the elderly are most likely to hurt themselves.  The better we understand about a society’s ills, how her people eat and live, how they die – the better we are able to contextualize the impact of governance systems and political regimes.

Just thinking out loud now…for all the talk of a Twitter revolution in Iran last summer, the power of 140 characters is only strong enough to continue fanning the flames of an already stoked fire.  A lasting movement – whether it be one of moderate ideology or something more akin to revolution – needs the power of deep seeded ideas, and this is best done by increasing knowledge in a society.

Knowledge of healthcare is particularly well suited to the task of bringing about positive societal change.  There is the immediate benefit of such knowledge to empower individuals, families, and communities to make choices that will improve their well being and, in some cases, considerable lengthen life.  The less obvious benefit is that developed healthcare systems and increased public awareness of public health lead to a shift in the nature of political discourse.  Regimes – democratic, tyrannical, or what have you – are forced to change because the stated and expressed priorities of the people are also now changed.

We are seeing in today’s China how a population more in tune with their healthcare needs is placing ever-louder pressure on the government to create better hospitals, clamp down on corruption in the medical fraternity, and even make the environment a littler greener.  This is not being done through a network of foreign NGO’s or through the editorials of foreign newspapers.  It is happening from the inside of private homes, and through dialog within Chinese families.  Knowledge has been and always will be the truest catalyst of change.

Study excerpt from Science Daily is reprinted below.

Falls the Leading Cause of Injury Among Older Adults in China

ScienceDaily (Aug. 5, 2010) — Falls are the most common injury for both urban and rural elderly in China, responsible for more than two-thirds of all injuries in people 65 and older, according to a new study by researchers from China and the Johns Hopkins Bloomberg School of Public Health’s Center for Injury Research and Policy. This is the first study to uncover the leading causes of non-fatal injuries among older adults in China, who make up 9 percent of the total population. The report is available on the website of the journal Injury Prevention.

The researchers also examined the most common places of injury occurrence and the influence of marital status on injury. More than 70 percent of all injuries occurred in the home or in the street, with public buildings being the third most common place of injury for rural residents. Marital status was found to be a significant predictor of sustaining an injury; specifically, the divorced and widowed had 4.6 and 2.2 times the risk of injury, respectively, as elderly who were single.

“The identification of the most common locations and causes of injury is useful for the development of interventions and priorities,” said Susan P. Baker, MPH, professor with the Injury Center. “The results indicate the divorced and widowed elderly should be targeted as high-risk groups for injury. Prevention programs for all major causes of injury need to be developed as soon as possible in China.”

The researchers analyzed data from the 2008 National Health Services Survey of China, conducted once every five years to help the government understand the need for and supply of health services. The survey is administered through face-to-face interviews with representatives from over 56,000 households.

“Importantly, 2008 marked the first year the National Health Service in China has included injury in their survey,” said Guoqing Hu, PhD, lead study author and associate professor of epidemiology and health statistics at Central South University in China. “This is an important milestone, and we hope it signifies greater investment in injury control moving forward.”

Support for this research was provided by the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (Grant # CCR302-2486), the Center for Health Statistics and Information of the Ministry of Health of China, and the China Medical Board of New York.