May 1999

• Each year 150,000 Americans die as a result of injuries
• An estimated 70 million suffer nonfatal injuries
• Injury is the third overall cause of death in the country
• It is the second most costly health problem after heart disease
• Injuries kill more American ages 1-34 than all diseases combined

As a leader in the field of injury prevention, EDC’s Susan Gallagher understands just how difficult it can be to change ingrained habits and beliefs. "20 years ago, people laughed at me when I talked about the use of car seats for children as part of routine health care practice," she says. "They said it would never happen." In the two decades since then, she has seen her pioneering work to promote a public health approach to injury prevention lead to car seat requirements for children nationwide.

During those same years, many other injury prevention campaigns have also made significant improvements in the lives and health of Americans, young and old—the widespread adoption of bicycle helmets, seat belts, smoke detectors, and childproof medicine caps to name just a few.

But affecting social change on such a large scale is not easy. "Public education is important," explains Gallagher, "but education alone is not enough." A successful injury prevention campaign also requires strong advocacy at the local, state, and federal levels to produce product safety changes and other regulatory and legislative efforts, as well as enforcement policies. Gallagher points to the car seat initiative as an example of an injury prevention campaign that included a proven safety technology, widespread public education, legislative support, and the law enforcement community willing to back it up. Similar approaches can be applied successfully to other safety hazards, from house fires caused by slow-burning cigarettes to firearm injuries and suicides.

As a public health researcher, practitioner, and advocate, Gallagher has fought hard for many such initiatives. The lessons she has learned along the way form the core of her new book, Injury Prevention and Public Health: Practical Knowledge, Skills, and Strategies (co-authored with Tom Christoffel). Written for public health practitioners and students, the book works from the premise that in most cases "injury is not an accident"—not the result of unpredictable or unavoidable occurrences. Instead, most injuries are foreseeable events with known causes and risk factors—and are therefore preventable.

Injury Prevention and Public Health stands out from previous books on the subject because of its emphasis on practical approaches. It combines the latest information on injury prevention research with proven strategies for implementing effective programs. "While most books deal with the data and an assessment of the problem," says Gallagher, "this book focuses on what you can do about the problem. It goes beyond the data to talk about who the players are and what are the successful strategies and the significant barriers. It’s really a practitioner’s book."

One of the public health challenges energizing Gallagher and her colleagues these days is the reduction of firearm injuries. "Many people don’t realize that firearms are extremely under-regulated when compared with other consumer products," she explains. Cars, toys, and potentially toxic substances like medicines all come with standard safety features to reduce the incidence of misuse and injuries. "Why shouldn’t there be safety features on a gun, and why shouldn't they be in the same place regardless of the manufacturer, like the brake in a car?" she asks. She points to several  viable safety features and strategies for reducing the misuse of firearms: load indicators, child-restraint devices such as trigger locks, personalized handguns that by design can be fired only by the owner, and prohibiting toy guns from closely resembling real guns. "Firearm manufacturers are in the same place that automobile manufacturers were in the 1960s and early ‘70s," she explains. "They did few studies and little on safety until they were required to by law. So the public health community is pushing hard now for firearm safety standards."

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For more information:

Contact Susan Gallagher, Senior Scientist and Associate Director of EDC’s Center for Injury and Violence Prevention.

Visit EDC’s online publications catalogue for ordering information.

Visit the Health and Human Development website.