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Injury and violence: a public health perspective
  1. Ian Rockett
  1. Exercise Science/Community Health Research Group, University of Tennessee, Knoxville, Suite 309, Conference Center Building, Knoxville, Tennessee 37996-4133, USA Tel: +1 865 974 4511, fax: +1 865 974 4521 e-mail: irockett{at}

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    Editor,—Your editorial in the June 1999 issue of Injury Prevention contained a brief review of my Population Bulletin entitled Injury and Violence: A Public Health Perspective.1 In general, the comments were extremely positive, for which I am most grateful. But I am puzzled by the charge that the bulletin dwells on the mechanics of injury control at the expense of the “public health...spirit”.

    My target audience comprises two main groups. The first is students in the population sciences, medicine, and public and allied health. The second group is public health professionals who are unfamiliar with the field of injury control. While I readily concede that I was motivated to introduce them to the mechanics, I also endeavoured to share the public health spirit that is so pervasive in the field. The latter effort can be illustrated through reference to some of the ideas and material contained in the bulletin.

    In documenting the magnitude of injury and violence, I computed rates from cause of death and population counts published in The Global Burden of Disease.2 This marks the first time to my knowledge that truly global injury mortality rates have been presented in the literature. Building on the data accumulation by the World Health Organization, similar data on injury and disease should be routinely compiled and made easily accessible. They would assist many countries in assessing whether given cause-specific injury mortality rates are excessive, and, where so, in making the case for an appropriate public health response. As we know too well, the public health pie is far from infinite.

    Your editorial implied that the bulletin's stress on surveillance systems and other data sources was prima facie evidence of my mechanical approach to the topic. But overlooked was the concomitant focus on data quality. The bulletin's target audience contains future change agents, people who can inspire and educate users to view injury and other public health data through a critical lens. Acquisition of accurate data is the sine qua non for sound scientific research, including risk group and risk factor identification and intervention evaluation.

    The editorial mentions my discussion of macroepidemiology in a section on future directions. I believe this section clearly reflects the public health spirit. In it I advocate the need for macroepidemiology to add injury and violence to the mix of adverse health outcomes to be investigated in relation to gross environmental shifts. Not mentioned in the editorial, but also reflecting the public health spirit, is the space devoted to injury control's historical roots. These roots continually inform current initiatives and, equally important, challenge us to revolutionize the ways we confront and anticipate injury problems, intentional as well as unintentional.

    Editorial decisions and spatial constraints precluded greater elaboration of injury prevention strategies and countermeasures in the bulletin. And injury policy does receive less attention than it warrants. But to help offset these deficiencies, I hope the bulletin conveys to readers both a sense of the rationalism and optimism of the injury control field and appreciation of the abundant career and avocational opportunities that our field affords.

    In closing, and consistent with the aim of the bulletin, I applaud your decision to make Injury Prevention inclusive. This augers well for the development and longevity of the journal.


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