Injury prevention: Meeting the challenge

The book is divided into three parts. The first part is a primer on the process of identifying, strengthening and using existing resources. These chapters stress the importance of citizen involvement; of coalitions and other collaboration among key agencies and organizations; of data and other knowledge of the injury problems in the particular state and locality; and of local problems and conditions. The challenging task is to adapt and combine those research findings in light of local data and other resources, in order to design, monitor, evaluate, and modify a community program, and keep it on course toward the goal of reduced incidence of injuries and reduced mortality, morbidity, and disability. Part two of this book is a report on the state of the art and knowledge in regard to major determinants of injuries. This information provides an excellent starting point for a planning group in a particular community. It will help such a group avoid many pitfalls, but it will not give them a blueprint for their program. Each program must be tailored to fit the unique problem characteristics, conditions, and populations of the particular setting and then 'tried on' (implemented, monitored, and evaluated) repeatedly. This will provide management with the information necessary to determine how the program must be modified, even as it is being implemented, in order to realize better or sooner the goal of prevention and control. Plans should include provision for such periodic 'adjustments' throughout the life of the program. Part three describes the community response to persons who are severely injured. While it is obviously most desirable that we minimize the number and severity of injuries, we must also minimize the negative consequences of those injuries. We can reduce the number of deaths that result from injuries. We can reduce the severity and duration of disability, the number of days of hospitalization, the period of absence from work or school or normal daily living. And we must remember the enormous negative consequences that injuries have for persons close to the victims. Emergency medical service systems and trauma care systems, in particular, are the community's response to the severely injured individual and his or her family. The strengthening of these systems must be a high priority.