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Reducing the burden of injury
  1. Frederick P Rivara
  1. Chair, ISCAIP Harborview Injury Prevention and Research Center, Box 359960, 325 Ninth Ave, Seattle, WA98104, USA (Tel: +1 206 521 1530; fax: +1 206 521 1562; e-mail:

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    Last month, the Institute of Medicine of the National Academy of Sciences issued a new report on the status and future of injury research, Reducing the Burden of Injury: Advancing Prevention and Treatment.1 In the pages of this journal, Baker recently discussed the importance to the field of the prior Institute of Medicine report,2Injury in America.3 This report was precipitated in part by the crisis at the Centers for Disease Control and Prevention over firearm research, and in part by the perceived need to re-energize the field to accomplish the goals laid out in Injury in America. What does this report have to say about child and adolescent injury prevention, and what does it mean for ISCAIP?

    While much of the report is fairly parochial to the United States, it does contain information and recommendations relevant to the field around the world. One very important issue addressed directly by the report is whether the field should legitimately include violence or whether it rightfully belongs to disciplines outside the injury field. This very issue was discussed by ISCAIP in Amsterdam at our meeting and by me previously in this column.4 The report concluded, as we have, that all injury prevention, including both intentional and unintentional injury, should be integrated into the same common framework of research. The inclusion of injuries regardless of intent in surveillance systems, the commonality of the agencies carrying out prevention, and the existence of risk factors which cut across intent argue strongly for inclusion of intentional injuries within the scope of injury research and prevention.

    Unfortunately, the report in some ways muddies the waters of our field by rejecting the use of the term injury control. This term came about through the work of Haddon and his colleagues …

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