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Injury prevention is growing up!
  1. Terry Nolan
  1. Professor, Department of Paediatrics (University of Melbourne), Clinical Epidemiology and Biostatistics Unit, Level 4, Front entry building, Royal Children's Hospital, Flemington Road, Parkville 3052, Australia (Phone: +61-3-9345-6363, fax: +61-3-9345-6000, e-mail: nolan{at}cryptic.rch.unimelb.edu.au)

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    Injury Prevention has rapidly established itself as the lead journal in its field. Although there are sister publications that address issues of injury causation and consequences, no other journal has embodied the full scientific spectrum from epidemiology, causation, and outcomes, to countermeasure development, implementation, and evaluation. In fact this successful concentration on child and adolescent injury has thrown into sharp relief the need for the same comprehensive approach to research dissemination across all ages.

    A focus on child injury has provided the catalyst for better organised and systematic community approaches to injury prevention in a number of countries. Such has been the case in the United Kingdom and Australia after establishment of trusts or foundations that have had a profound impact on community and government responses to the importance of injury prevention. Injury surveillance has been an important contributor to this.

    In Australia, injury surveillance was developed, piloted, and implemented for children's injuries in the first instance before being expanded to cover injuries in persons of all ages.1,2

    Successful integrated models of injury prevention incorporate rigorous scientific principles, including those that recognise the importance of social determinants and modifiers of risk and countermeasure success. Such models seek to identify the uniqueness of the human, environmental, biomechanical, social and indeed political factors that mediate particular injuries. This includes age, of course, and the counterparts of those special conditions applying to the young are just as important to recognise in the elderly and indeed at all stages of life.

    Injury prevention research has been relatively poorly funded throughout the world, and especially in the emerging market economies of the third world. Recent developments have, however, begun to influence research expenditure around the world. Government, corporate, and philanthropic backers of research want more of a say in how their research investment is spent, particularly focusing on demonstrable gains in health as a result of that investment.

    In the United States and Australia, for example, major reviews of research expenditure have led to substantial increased government commitment to funding health and medical research of all kinds, but especially research that addresses health priorities, particularly those that reflect high levels of health spending.3,4

    In Australia, this focus has also led to the establishment of a national advisory council on injury prevention, production of a major analysis of research needs in the injury prevention area,5 and new national strategies for both research and action on injury prevention.6,7 Some of this discovery of the importance of prevention and orientation to so-called strategic research has been influenced by the World Bank and World Health Organisation ad hoc committee report on health research8 and the associated Global Burden of Disease project.9 In the latter exercise, Murray and Lopez demonstrated that injury is a major contributor to global death and disability,9 particularly injuries attributable to road trauma and to falls. They project that by 2020, road traffic injury (ranked ninth in 1990) will rank third in the league table of global disability burden behind only ischaemic heart disease and major depression. War and violence may, on their estimates, increase their world ranking from 16 to 8 and from 19 to 12 respectively.

    The challenge for the research community is to harness this new support, and to pick up the pace on injury prevention research, especially in relation to the developing world. In its new form Injury Prevention will be well placed to promote this growth and particularly to encourage publication of injury research likely to benefit all, particularly those in the emerging market economies.

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