Article Text

Download PDFPDF
Equity as the fourth ‘E’ in the ‘3 E’s’ approach to injury prevention
  1. Audrey Giles1,
  2. Michelle E E Bauer2,
  3. Janet Jull3
  1. 1 School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
  2. 2 School of Population Health, University of Ottawa, Ottawa, Ontario, Canada
  3. 3 School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
  1. Correspondence to Dr Audrey Giles, School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N, Canada; agiles{at}


The education, engineering and enforcement (3 E’s) approach to injury prevention is grounded in assumptions that it is effective for everyone; however, evidence demonstrates that it fails to consider opportunities for all populations to experience safe and injury-free lives. In this way, the 3 E’s approach does not support health equity in the injury prevention field. In this brief report, we argue that a fourth E, equity, must also be used with the 3 E’s approach to injury prevention.

  • Injury prevention
  • Equity
  • Health disparities
  • Education
  • Engineering
  • Enforcement

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors All three authors made substantial contributions to the conceptualisation of the work, drafted the work and approved the final version for publication.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.