Recent Advances in Injury Prevention
Joseph Greensher MD1
1 Professor of Clinical Pediatrics, State University of New York at Stony Brook, and Department of Pediatrics, Winthrop-University Hospital, Mineola
Injuries are the nation's foremost public health problem affecting children, claiming more lives than the six other leading causes of childhood deaths. Almost half of all children's deaths between the ages of 1 and 14 years are due to injuries, as are 80% of those 15 to 23 years, if homicides and suicides are included (Table).
[See table in the PDF file]
The data regarding incidence of nonfatal injuries are also disturbing, especially because only more serious cases are reported: each year at least 19 million children 15 years of age and younger are treated for severe injuries; 100,000 of these youngsters are left with permanent disabilities.
Before World War II, accidents were generally considered unavoidable, the function of careless individual behavior, if not fate. By the 1950s, however, it was recognized that injuries, like most diseases, could be controlled if they were identified as a public health problem amenable to study and intervention. The model (Fig. 1) of an interacting host, agent, and environment superseded the notion of "accident," and three main preventive strategies emerged: (1) Education/Persuasion: to modify behavior by making people aware of hazards and of ways to avoid or eliminate them. (2) Legislation/Enforcement: to require by law behavior or conditions that help ensure safety or, at the least, do not endanger.
