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Would society pay more attention to injuries if the injury control community paid more attention to risk communication science?
  1. D C Girasek
  1. Correspondence to:
 Dr D C Girasek
 Department of Preventive Medicine, Uniformed Services University, 4301 Jones Bridge Road, Bethesda, Maryland 20814, USA; Dgirasek{at}

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“If a disease were killing our children at the rate unintentional injuries are, the public would be outraged and demand that this killer be stopped.” Former US Surgeon General, C Everett Koop

Whenever injury control professionals gather, it doesn’t take long for the conversation to turn to one topic: “Why is it that more attention and resources aren’t devoted to injuries, the leading cause of death for children and young adults?” One early hypothesis—that people think injuries cannot be prevented—has not held up to scientific scrutiny.1–6 Another possible explanation, however, may be found in the risk communication literature.

Since the 1980s, corporate and government officials have turned to risk communication experts for help with a problem contrary to our own: why do communities “overreact” to hazards that pose minimal risk from an epidemiological perspective?7 In such situations, environmental engineers and safety experts characterize lay people’s views as irrational or ignorant.8 For example, in a national (US) survey, more than twice as many parents worried about their children being kidnapped than being involved in an “automobile accident”.2 Many professionals assumed that if they shared more data with the public, enlightenment would follow. The risk communication literature suggests, however, that scientists may also benefit from enlightenment.8

Most Americans know that injuries are a leading cause of death,9,10 yet they display little concern for injury prevention. In trying to explain this disconnect between vital statistics and public support, psychometric researchers have identified qualitative dimensions of risk not captured by epidemiologic methods. Sandman conceptualizes Risk, as it is perceived by the public, as a function of Hazard + Outrage.8 His “hazard” refers to the statistical calculation of risk that professionals generally rely on. “Outrage”, on the other hand, is more emotional and predicts an issue’s …

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  • Competing interests: none.