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Tasty books
1. I B Pless, Editor

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It is not often that editorial space is used to review books, but several recent publications seem so pertinent I could not resist. I realise that most readers have sufficient difficulty consuming all the journals they wish and that reading a book is far more time consuming. That is why reviews are important. I assure you these are worth the trouble.

Recommending books is, however, much like preparing a banquet. Few chefs intend that every dish be eaten to the last mouthful. Instead, they tempt us to savour bits here and there and hope that on another occasion, when we are hungrier or have more time, we will return to try some more.

In the case of the five books that prompted this departure from editorial custom, one is short enough to be digested at a single sitting; two are full course meals, and the last two, because they are so satisfying and easily digestible, deserve the ultimate commitment.

The first is actually a 40 page bulletin written by Ian R H Rocket entitled Injury and Violence: A Public Health Perspective.1 What makes it special is that a large and complex picture is portrayed well in so few pages. The book is clearly intended primarily for American readers, but the issues are viewed in an international context. And although much of the material is well known, a section addressing future directions identifies some emerging technologies like geographic information systems and the role of macroepidemiology.

One shortcoming is that the “public health perspective” touted in the title only addresses the mechanics of public health, not its spirit. There is scant evidence of the passion that has driven much of public health in the past. This is not a minor quibble. Surveillance systems are important, to be sure, but there is (or should be) much more to public health than collecting data. This branch of medicine has a distinguished tradition of focusing on policy and it is a discipline that is as committed to action as it is to furthering understanding. These elements are difficult to find in Rocket's otherwise admirable contribution. None the less, this is an excellent primer—well written, well illustrated, remarkably complete, and readily affordable.

The second is Reducing the Burden of Injury: Advancing Prevention and Treatment.2 In 1985, a Committee on Trauma Research published its landmark report Injury in America. Shortly after this the National Center for Injury Prevention and Control (NCIPC) was created—a centre with a mandate and funding that is a model in many respects, as well as a source of envy. The progress of NCIPC was reviewed two years later by another Institute of Medicine/National Research Council (IOM-NRC) sponsored committee whose report, Injury Control, appeared in 1988.

About 10 years later the IOM decided to revisit the issue. A new expert committee on injury prevention and control was assembled, which, incidentally, included many members of the editorial board of this journal. The panel met frequently, held several open hearings, invited experts, and finally prepared this thoughtful and often provocative report. We owe a large debt of gratitude to the IOM and the foundations that funded these deliberations. Few other countries could afford the extensive input on which the report is based. And, like Injury in America, no one is expected to read this book from cover to cover, certainly not at a single sitting.

Reducing the Burden of Injury addresses many emerging issues in the field. Although, understandably, most are framed in the context of current social and political realities in the US, many of the recommendations pertain to all of us. Of the nine chapters three—Prevention Research, Case Studies on Prevention, and Challenges and Opportunities—are the most widely applicable to other countries.

The tone of the document is generally authoritative, although it is perhaps a bit more diplomatic in some sections than I would have wished. To its credit, it takes on a number of tough issues. For example, on the contentious question of whether violence should continue to be part of the agenda, the committee concluded, unanimously, that it should. “ . . .. Despite important differences associated with intentionality, [we] strongly endorse the continued integration of all injury prevention activities within a common framework of research and program development” (ix). Other controversies, such as the struggle between regulation and freedom, are acknowledged repeatedly.

With respect to research, three promising areas are identified: biomechanics (pp 96–8), biological sciences (pp 99), and behavioral sciences (pp 99–101). In the latter, emphasis is placed on studying differences in risk perception, risk taking, and behavioral responses to safety improvements among different segments of the population. Without equivocation, the book affirms that injury is a public health problem (pp 23) while stressing the vitally important role of other disciplines. It adds, however, that “proactive `marketing' of public health is needed to arouse public awareness and concern, to counteract complacency or sluggishness, and to prod policy makers into action” (pp 199).

Reminiscent of some of the points raised in a previous issue of the journal, the section on prevention research concludes with an interesting observation: “Surprisingly few researchers have explored empirically the operation of the market for safety, the effects of tort liability, and the effects of regulatory action . . .”. Regarding the safety effects of tort liability, the authors add, “public health proponents typically assume that expansive liability rules are safety enhancing, whereas sceptics believe that the existing liability scheme tends to reduce safety by retarding innovation or inducing override behavior” (p 93).

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