Burn injury and gender inequity: epidemiological insights and social determinants
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20254073Keywords:
Burn injuries, Gender disparities, Women’s health, Domestic violence, IndiaAbstract
Burn injuries pose a significant global health burden, with the overwhelming majority of deaths around 90% occurring in low and middle-income countries (LMICs). India alone reports an estimated 6–7 million burn cases annually, ranking among the highest globally. Women are disproportionately affected due to unsafe cooking practices, flammable traditional clothing, use of hazardous fuels, and gender-based violence. Socio-cultural norms and economic constraints further increase vulnerability and delay timely access to care. This review explores the gendered dimensions of burn injuries in India, including epidemiology, risk factors, healthcare access, psychosocial impact, and policy responses. A thorough review of the literature was carried out using PubMed, Google Scholar, and the World Health Organization (WHO) Global Health Library, along with grey literature from government and policy sources. Data were thematically synthesized into key domains to identify patterns in injury causation, severity, treatment gaps, and intervention strategies. Evidence indicates that women experience more severe burns and higher mortality even with smaller burn surface areas, largely due to delayed care, financial barriers, and gender bias in healthcare delivery. Intentional burns resulting from domestic violence, dowry-related harassment, and self-immolation substantially contribute to the burden, although misclassification of such cases is common. Psycho social stigma, insufficient mental health support, and limited rehabilitation services further hinder recovery and social reintegration. Addressing these disparities requires gender-responsive approaches, including disaggregated surveillance, integration of violence screening into burn care, strengthened rehabilitation services, community-based prevention, and public awareness initiatives. Legal protections and training healthcare providers in gender-sensitive care are critical to reducing inequities. A coordinated, multi-sectoral strategy is essential to ensure equitable outcomes and mitigate the disproportionate impact of burn injuries on women in India.
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References
Gautam R, Rajoura OP, Sharma AK, Rajpal, Bhatia MS. Socio-demographic features and quality of life post burn injury. J Family Med Prim Care. 2022(3):1032-5. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1172_21
Gupta JL, Makhija LK, Bajaj SP. National programme for prevention of burn injuries. Indian J Plast Surg. 2010;43:S6-10. DOI: https://doi.org/10.4103/0970-0358.70716
Bhate-Deosthali P, Lingam L. Gendered pattern of burn injuries in India: a neglected health issue. Reproductive Health Matters. 2016;24(47):96-103. DOI: https://doi.org/10.1016/j.rhm.2016.05.004
Mehta K, Arega H, Smith NL, Li K, Gause E, Lee J, et al. Gender-based disparities in burn injuries, care and outcomes: A World Health Organization (WHO) Global Burn Registry cohort study. Am J Surg. 2022;223(1):157-63.
World Health Organization (WHO). Global Burn Registry cohort study. Am J Surg. 2022;223(1):157-63. DOI: https://doi.org/10.1016/j.amjsurg.2021.07.041
Golshan A, Patel C, Hyder AA. A systematic review of the epidemiology of unintentional burn injuries in South Asia. J Public Health (Oxf). 2013;35(3):384-96.
Golshan A, Patel C, Hyder AA. A systematic review of the epidemiology of unintentional burn injuries in South Asia. J Public Health. 2013;35(3):384-96. DOI: https://doi.org/10.1093/pubmed/fds102
Harshitha K, Raghava V, Mahesh C. Social and psychological profile of pattern of female burn casualties. Egypt J Forensic Sci. 2022;12(1):61. DOI: https://doi.org/10.1186/s41935-022-00319-w
Kumar V, Tripathi CB. Fatal accidental burns in married women. Legal Med (Tokyo). 2003;5(3):139-45. DOI: https://doi.org/10.1016/S1344-6223(03)00075-0
Global Burden of Disease Cancer Collaboration. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study. JAMA Oncol. 2017;3(4):524.
Forjuoh SN. Burns in low-and middle-income countries: a review of available literature on descriptive epidemiology, risk factors, treatment, and prevention. Burns. 2006;32(5):529-37. DOI: https://doi.org/10.1016/j.burns.2006.04.002
McGwin Jr G, George RL, Cross JM, Reiff DA, Chaudry IH, Rue III LW. Gender differences in mortality following burn injury. Shock. 2002;18(4):311-5. DOI: https://doi.org/10.1097/00024382-200210000-00004
Lam NN, Hung NT, Duc NM. Influence of gender difference on outcomes of adult burn patients in a developing country. Ann Burns Fire Disasters. 2019;32(3):175-8. DOI: https://doi.org/10.1016/j.burnso.2019.05.003
Ministry of Health and Family Welfare. National Programme for Prevention of Burn Injuries (NPPBI) – Operational Guidelines. Government of India. 2013.
Shankar G, Naik VA, Powar R. Epidemiolgical study of burn injuries admitted in two hospitals of North Karnataka. Indian J Community Med. 2010;35(4):509-12. DOI: https://doi.org/10.4103/0970-0218.74363
Honnegowda TM, Kumar P, Udupa P, Rao P. Epidemiological study of burn patients hospitalised at a burns centre, Manipal. Int Wound J. 2019;16(1):79-83. DOI: https://doi.org/10.1111/iwj.12995
Daruwalla N, Belur J, Kumar M, Tiwari V, Sarabahi S, Tilley N, et al. A qualitative study of the background and in-hospital medicolegal response to female burn injuries in India. BMC Women's Health. 2014;14(1):142. DOI: https://doi.org/10.1186/s12905-014-0142-5
Newberry JA, Bills CB, Pirrotta EA, Barry M, Rao GV, Mahadevan SV, et al. Timely access to care for patients with critical burns in India: a prehospital prospective observational study. Emerg Med J. 2019;36(3):176-82. DOI: https://doi.org/10.1136/emermed-2018-207900
Prinja S, Jagnoor J, Chauhan AS, Aggarwal S, Nguyen H, Ivers R. Economic burden of hospitalization due to injuries in North India: a cohort study. Int J Env Res Public Health. 2016;13(7):673. DOI: https://doi.org/10.3390/ijerph13070673
Kumar V, Tripathi CB. Burnt wives: a study of homicides. Med Science Law. 2004;44(1):55-60. DOI: https://doi.org/10.1258/rsmmsl.44.1.55
Belur J, Tilley N, Daruwalla N, Kumar M, Tiwari V, Osrin D. The social construction of ‘dowry deaths’. Social Sci Med. 2014;119:1-9. DOI: https://doi.org/10.1016/j.socscimed.2014.07.044
Jagnoor J, Bekker S, Chamania S, Potokar T, Ivers R. Identifying priority policy issues and health system research questions associated with recovery outcomes for burns survivors in India: a qualitative inquiry. BMJ Open. 2018;8(3):e020045. DOI: https://doi.org/10.1136/bmjopen-2017-020045
Chamania S, Chouhan R, Awasthi A, Bendell R, Marsden N, Gibson J, et al. Pilot project in rural western Madhya Pradesh, India, to assess the feasibility of using LED and solar-powered lanterns to remove kerosene lamps and related hazards from homes. Burns. 2015;41(3):595-603. DOI: https://doi.org/10.1016/j.burns.2014.09.001
Peck MD. Epidemiology of burns throughout the world. Part I: Distribution and risk factors. Burns. 2011;37(7):1087-100. DOI: https://doi.org/10.1016/j.burns.2011.06.005