Childhood injuries: The community approach to prevention

ACENTURY ago, it was not uncommon for several children in a single family to die before reaching their third birthday. Many children died because of water-and milk borne pathogens, many others of diseases preventable by immunization such as diphtheria and pertussis. These diseases were not man-made, but they could be prevented by man, and indeed they are now rare in the industrialized countries of the modem world. In their stead, injuries are now preeminent as a cause of death and disability in children. Unlike childhood diseases, the overwhelming majority of injuries are caused by man-made hazards-hazards that can be eliminated, reduced, or changed in ways that will reduce childhood injuries. Today it is feasible to prevent many serious injuries, using community approaches that would automatically protect large numbers of children (1-3). Yet 12, 000 children less than fifteen years old will be killed this year in the U.S. alone. In the 0-4 age group, more than 5, 000 will die, thousands more will be permanently disabled, and 6 million injuried less seriously.