MedicalResearch: What are the main findings of the study?
Dr. Haegerich: In the first three decades of life, more people in the US die from injuries and violence than from any other cause. Approximately 60% of fatal injuries are unintentional (for example, from motor vehicle crashes, drug overdose, and falls), 20% are due to suicide, and 20% are due to homicide. Injuries and violence have been linked to a wide range of physical, mental health, and reproductive health problems, and chronic diseases. They take an enormous economic toll, including the cost of medical care and lost productivity. Importantly, injuries and violence are preventable through education, behavior change, policy, engineering, and environmental supports. For example, laws that promote the use of seat belts and child safety seats, and prevent drunk driving, can reduce motor-vehicle-related injuries. Early childhood home visitation, school-based programs, and therapeutic foster care are examples of evidence-based approaches to preventing violence. Improving proper prescribing of painkillers and access to treatment for substance misuse could prevent prescription drug overdoses. Improvements are possible by framing injuries and violence as preventable, identifying interventions that are cost-effective and based on research, providing information to decision makers, and strengthening the capacity of the health care system.
MedicalResearch: Were any of the findings unexpected?
Dr. Haegerich: The findings are concerning. Nearly 180,000 people in the US die every year from injuries and violence related to preventable events such as car crashes, drug overdoses, falls, assaults, drowning, and self-harm. This means that there is one injury death approximately every three minutes.
MedicalResearch: What should clinicians and patients take away from your report?
Dr. Haegerich: In clinical settings, injury prevention is not integrated fully in practice. Patients are not as familiar with ways to prevent injuries as they are with those for other major killers such as heart disease. Health providers can implement screening and referral for injury risk factors, such as depression, domestic violence, alcohol misuse, and behavioral problems in children. Health systems can integrate clinical decision support for injury prevention within electronic health records so that clinicians can easily follow guidelines and assessment protocols. Patients can talk to their physicians about their risk for injuries and violence – for example, if they are having problems with depression, substance use, or within their personal relationships.
MedicalResearch: What recommendations do you have for future research as a result of this study?
Dr. Haegerich: Researchers can develop the science to better understand the burden, effective prevention strategies, and how to get research translated into practice. Better tracking and monitoring is needed to allow more timely and accurate data. Interventions need to be rigorously tested to determine their health effects and return on investment for the health system. We require a better understanding of how to get practitioners to use evidence-based strategies and implement them as they are intended. Overall, research can inform how to change environments to make safe choices the easier choices.