Injury Prevention

Injury Prevention: Accomplishments and Challenges

By: Garry Lapidus, PA-C, MPH

I have seen a lot of progress in the field of injury and violence prevention over the 30 years that I have been part of it. Advancements in this field have saved an untold number of lives around the country. However, as a field, we still have many hurdles to overcome.

I was honored to recently present Pediatric Grand Rounds at Connecticut Children’s and focused my presentation on the many accomplishments we have achieved in this field, as well as the challenges that still remain. This blog highlights some of those accomplishments and challenges.

In terms of our successes, drunk driving deaths are down over the past 30 years. Pedestrian and bicycle deaths are also down over that time frame, despite a measurable and concerning uptick in the last year. We have also made significant progress in reducing deaths related to falls and drowning.

Unfortunately, we are still stymied by the huge problem of child maltreatment and intimate partner violence. There are additional areas in which problems are getting worse, such as infant suffocation, motorcycle injuries, opioid overdoses, suicide, and gun violence.

I learned a valuable lesson early in my career that I have carried with me through the years. While working at the Mount Sinai Hospital in Hartford, we would see person after person come into the emergency department for treatment of what were referred to as “accidents.” Those “accidents” included a variety of causes, such as car crashes, falls, cooking incidents, sports injuries, and much more. We now know that injuries are not accidents. They are predictable and preventable.

As a field, we are in a great position to continue our important work thanks to growing recognition of the importance of injury and violence prevention over the last three decades. The Centers for Disease Control and Prevention established an Injury Control Research Center in 1989. Connecticut Children’s Injury Prevention Center launched in 1990, before the hospital was built. Since 2006, the American College of Surgeons required all Level 1 Trauma Centers to have an injury prevention coordinator. Also, we now have critical data systems, such as the National Violent Death Reporting System, to inform our work.

In Connecticut, one of the biggest areas in which we have seen dramatic improvement is with fatal car crashes involving teenage drivers. Our Injury Prevention Center successfully lobbied with the Connecticut Department of Motor Vehicles and other organizations for a graduated driver licensing law, in which driving privileges for teenagers are phased in over time. Since implementation of those laws, deaths involving teenage male drivers are down 113 percent and deaths involving teenage female drivers are down 82 percent.

We have also seen reductions in fatalities over the past 30 years resulting from increased use of car seats, booster seats and seat belts.

Read additional blogs from Garry Lapidus, PA-C, MPH here.

We still have much progress to be made with motorcycle fatalities, where deaths are up 55 percent over the past 30 years. To date, only 19 states require all riders to use helmets. In Connecticut, only those under the age of 18 must wear one, something we continue to try to change.

We must focus on other remaining challenges too, such as firearm violence, suicide prevention, vaping, and the opioid epidemic. On any given day, about 665 Americans will die from a preventable injury, which remains the leading cause of death in our country. The costs for non-fatal injuries are high, at an estimated $671 billion dollars each year.

The fact that all deaths for people ages 0 to 19 are down 21 percent in the United States over the past 18 years is a promising sign that injury and violence prevention efforts are paying off. Our field has moved forward. We know it works. While challenges remain, we have made so much progress. In looking back on the last 30 years that I have worked in this field, one of the greatest privileges for me has been driving progress on all of these issues and saving lives.

Garry Lapidus, PA-C, MPH, is the director of Connecticut Children’s Injury Prevention Center, which is a program of Connecticut Children’s Office for Community Child Health. Lapidus is also an associate professor of pediatrics and public health at the UConn School of Medicine.

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