Background Surveillance and analyses of unintentional injuries can help prioritise community prevention efforts. Community based safety promotion programs aimed at reducing injuries high-risk groups, including children, elderly and people in traffic environments, have been ongoing in the Swedish communities of Falkoping and Lidkoping (31,000 and 38,000 inhabitants respectively) over the past three decades (both are designated as Safe Communities).

Methods This study describes changes in local patterns for unintentional injuries resulting in outpatient visits to health care clinics and emergency rooms, hospitalizations and deaths, comparing information from two different study periods, 1978 and 2008. Injury cases were analysed, and confidence intervals were derived. Data for outpatient injuries were provided from the Skaraborg Injury Registration Unit. We also used data from the Swedish National Board of Health and Welfare’s national patient register and causes of death register.

Results The study results show significant decreases in outpatient visits from 130.5/1,000 to 107.2/1,000 (18 per cent) in Falkoping and from 143.9/1,000 to 88.8/1,000 (38 per cent) in Lidkoping. Available data from comparison communities in the south and mid-north of Sweden, the surrounding district of the study areas, and Sweden as a whole, showed increasing number of outpatient visits. No significant changes were shown for mortality or hospitalisation in the study areas.

Conclusions This study points to the importance of more systematic collection data of injury events treated at the outpatient level, particularly for communities where there are relatively low numbers of injury-related deaths and hospitalizations. It also shows that long-term action- programs can be successfully.