Injury and violence: a public health perspective.

This report examined injury and violence from a public health perspective. The discussion focuses on the magnitude of the problem, age and regional patterns, war mortality, motor vehicle accidents, natural disasters, US injury and violence mortality and morbidity trends by age, the history of injury, the relationship between energy and injury, similarities between disease and injuries, injury and violence prevention, risk factors, and medical care. The US has two Centers for Disease Control surveillance systems for monitoring behavior that increases the risk of injury or disease. A youth surveillance system surveys high school students about high risk behavior, such as use of weapons and nonuse of seat belts. The surveillance system misses the homeless and people without telephones and undersamples minorities, low income people, and males. Youth surveillance misses groups with high dropout rates, such as Blacks and Hispanics. Lower income people have higher disease and injury rates. US Black males are particularly vulnerable. Health professionals that aim to reduce injury risks must address underlying conditions that perpetuate poverty, such as residential segregation, racial discrimination, unemployment, and inferior educational opportunities. Survival of the injured is dependent on the speed with which Emergency Medical Teams can treat the injury. Treatment within the first hour is a critical determining factor. Specialized trauma centers and emerging technologies, such as geographic information systems, improve survival. The global diffusion of beliefs, values, and practices can promote or inhibit injury and violence.