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Better late than ever: confronting Greece's major health problem
  1. Eleni Petridou
  1. Department of Hygiene and Epidemiology, Athens University Medical School, 75 M Asias Street, Goudi, Athens 11527 Greece (Tel and fax: +30 1 777 3840, e-mail: epetrid{at}

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    It is frequently said that neither individuals nor nations can learn from the experience of others—they have to pay their own price before they recognize a problem and master their resources to confront it. Motor vehicle accidents have become major epidemics in most western countries before measures were successfully implemented to reduce the burden of death, disability, and unhappiness generated by these injuries. In Greece, mortality from motor vehicle accidents increased from 11 per 100 000 persons in the 60s to more than 23 per 100 000 persons in the late 90s, when Greece was competing with Portugal for the unenviable position of leading the European Union member states in the death toll from motor vehicle injuries. For over two decades the reaction of officials as well as lay people has been at best fragmented, sporadic, and uncoordinated and at worst inexcusably passive. During the 90s, however, it has become apparent to most people and political leaders that injuries in general, and motor vehicle injuries in particular, represent the number one health problem for Greece, a country that has been blessed with very low mortality from cardiovascular diseases and most forms of cancer. In 1991 several influential public health officials argued that the human factors were just as important as the poor road infrastructure in the web of causation of motor vehicle accidents. As a result the Center of Research and Prevention for Injuries among the Young (CEREPRI) was established.

    In 1997 CEREPRI took coordinating responsibility for a nationwide campaign to highlight the importance of road traffic accidents as a public health problem. Specifically, the campaign, that was supported by the Division General for Transportation (DG 7) of the European Commission and the European Transport Safety Council, targeted seat belt use as the most cost effective measure in reducing motor vehicle mortality.

    The campaign was one of the largest ever launched in Greece, since the antimalaria campaign in the early 50s and the vaccination campaign in the 60s. The results were carefully evaluated and, although the resources available to the campaign organizers were limited, it was effective in increasing seat belt use. Details about the organization and the evaluation of this program project are awaiting publication in the American Journal of Public Health1 and further analysis focusing on specific components of the campaign are currently under examination. An unexpected, but welcome, consequence was that several individuals and organizations who were key contributors in the broad “Coalition for Life” that launched the CEREPRI coordinated campaign was subsequently independently energized in their own fields of specific responsibility, competence, or expertise. Thus, injuries in general and motor vehicle injuries in particular are now widely recognized as a health priority in Greece allowing some optimism that the beginning of the new century will coincide with the long delayed turning point in the increasing secular trend of motor vehicle mortality.

    It is worth mentioning the positive role of the mass media, legislative initiatives, including among others upgrading the seriousness of non-compliance with the mandatory seat belt use and substantial increase in the respective fine, intensification of enforcement of seat belt law, and a movement towards introducing road traffic education in the school curriculum.