Reducing the Burden of Injury Advancing Prevention and Treatment (1999) / Chapter Skim
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5 Case Studies on Prevention
5 Case Studies on Prevention
Pages 115-137
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From page 115... ...
However, a similar comprehensive multidisciplinary approach has not been taken in relation to firearm injuries. The goal of this chapter is to explore the comprehensive approach that has been utilized successfully to promote motor vehicle safety and to recommend steps that could be taken to implement a similar effort to reduce firearm injuries.
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From page 116... ...
Had the mileage death rate of 1972 prevailed in 1996, the number of deaths would have been almost 110,000 rather than 43,399. It has been estimated that between 1966 and 1990, 243,400 lives were saved as a result of federal highway, traffic, and motor vehicle safety programs USA and FHWA, 1991~.
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From page 117... ...
In recent years, an increasingly sophisticated and comprehensive approach to the motor vehicle injury problem has developed that addresses safety issues for the driver, occupant, vehicle, and highway system (CDC, 1994~. The conceptualization of this approach has been based largely on the work of William Haddon, who developed models for the systematic exploration of countermeasures to reduce or prevent injuries involving components of the causal sequence leading to injury pre-crash, crash, and post-crash events (see Chapter 1 for a fuller description of the Haddon matrix; Haddon [1972, 19803~.
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From page 118... ...
Regulation and Legislation In 1966, legislation was enacted that marked a significant change in the nation's approach to reducing motor vehicle injuries. The National Highway Traffic and Motor Vehicle Safety Act authorized the federal government to set safety standards for new vehicles and equipment, and the Highway Safety Act of 1966 authorized the federal government to develop a coordinated national highway safety program.
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From page 119... ...
NHTSA funds research primarily on human factors and vehicle safety, while the Federal Highway Administration funds research on improving highway safety. Additionally, other federal agencies have focused on topic-specific transportation safety research.
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From page 120... ...
State offices of highway safety often work closely with driver licensing, driver education, state police, public health departments, and state highway departments, and provide a coordinating function across state agencies that have some responsibility for highway safety. Examples of effective use of 402 funding include evaluation of the effectiveness of motorcycle helmet laws, innovative programs to increase safety belt use, design and implementation of improved driver license examinations for different classes of vehicles, child safety seat programs, and evaluation of effects of changes in speed limits.
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From page 121... ...
It might be possible to eliminate serious motor vehicle injuries almost completely by disallowing motor vehicles that can exceed 25 miles per hour (mph)
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From page 122... ...
Additionally, mandatory motorcycle helmet laws remain controversial, although the evidence of effectiveness in preventing death and brain injury is well documented (Kraus et al., 1994; Kraus and Peek, 1995~. 2Primary, or standard, enforcement refers to the stipulation in the law allowing law enforcement officers to stop a driver on the basis of a safety belt use violation.
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From page 123... ...
Opportunities for Further Progress Although significant progress has been made in reducing motor vehicle injuries, not all developments have been positive, and there are important opportunities for further gains. Numbers of motor vehicle deaths have risen slightly in recent years, although the decline in the mileage-based death rate has continued (NSC, 1997~.
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From page 124... ...
However, whereas most motor vehicle injuries are unintentional, most firearm injuries are intentional. This difference in intentionality creates complexities in dealing with the emotional, psychological, and behavioral antecedents and consequences of firearm injury.
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From page 125... ...
used NEISS to estimate all nonfatal firearm injuries in the United States (Annest et al., 1995~. Vital statistics data compiled by the National Center for Health Statistics include information on suicide and unintentional injury as well as homicide deaths related to firearms (Fingerhut et al., 19921.
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From page 126... ...
Thus, it seems reasonable to recommend that Congress establish a regulatory structure, with suitable criteria, to govern the design of firearms, ammunition, and safety devices. Although formulating the regulatory criteria will require difficult judgments regarding the best ways to preserve the utility of firearms for legitimate purposes while reducing risks of unintentional injuries and unlawful uses, the committee encourages the Congress to undertake this important challenge.
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From page 127... ...
t994 Violent Crime Control and Law Enforcement Act banned manufac ture and sale of any ammunition magazines with a capacity in excess of 10 rounds and banned manufacture and sale of semiautomatic rifles and handguns with specific characteristics. 1996 Domestic Violence Offenders Gun Ban prohibited gun purchase by individuals convicted of a domestic violence misdemeanor.
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From page 128... ...
Patterns of mental stress related to prevalent or intimate exposure to gun injuries and death remain to be fully elucidated; such research is needed in multiple sociodemographic settings. Rigorous studies are required of the efficacy and effectiveness of interventions designed to reduce the risk of firearm injury.
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From page 129... ...
In the committee's view, further attention to this problem, both conceptually and empirically, is needed. This is a robust multidisciplinary research agenda that must be developed and implemented to identify optimal interventions for the reduction of firearm injuries.
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From page 130... ...
Further, the federal government has not used federal revenue streams as leverage for the adoption of firearm injury prevention measures as it has for prevention of motor vehicle injuries. There are opportunities for encouraging states to improve data systems and implement programs with the goal of reducing firearm injuries.
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From page 131... ...
In contrast to highway safety policy, no consensus has emerged among policy makers regarding many aspects of firearms policy. Although recent public opinion surveys reveal a large area of agreement on many policy issues (Teret et al., 1998)
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From page 132... ...
In 1995, firearms were the second leading cause of death among children ages 1~14 years (48 percent of those deaths were homicides; Fingerhut and Warner [19971~. In 1994, 185 children, ages ~14 years, and 327 adolescents, ages 15-19 years, died from unintentional firearm injuries (Ikeda et al., 1997~.
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From page 133... ...
Reducing firearm injuries requires a long-term perspective. Perfecting the technology and stimulating the market for safer firearms are important goals for today, even though the full payoff will not occur for decades to come.
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From page 134... ...
Strengthened firearm and firearm injury surveillance efforts and multidisciplinary research initiatives can bring the depth and breadth of scientific and engineering expertise that is needed to develop and evaluate innovative firearm injury prevention measures. Designation of a federal agency to have regulatory jurisdiction over firearm safety issues, enforcement of current regulations, particularly on access to guns by children and adolescents, and expansion of state and local prevention programs are all necessary components of an effective comprehensive approach.
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From page 135... ...
Arlington, VA: Insurance Institute for Highway Safety. Fingerhut LA, Warner M
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From page 136... ...
NHTSA (National Highway Traffic Safety Administration) and FHWA (Federal Highway Administration)
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From page 137... ...
1995. Evaluation of California's safety belt law change from secondary to primary enforcement.
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