Injury Prevention: Achieving Population-Level Change | Supplement, Injury Prevention

Editors: Natalie Wilkins, PhD; Roderick McClure MBBS, PhD; Karin Mack, PhD

Why this supplement, now?

Upon reviewing injury prevention’s recent history, the editors identified a developing struggle. Following injury prevention’s conceptualization as a public health problem in the 1960s, there was an escalation of knowledge relating to “what works” to prevent injury. However, while effective programs were developed, they have not often realized population-level impact. There has been tremendous progress in identifying and determining the efficacy of countermeasures for injury and violence prevention such as seat belts, speed limits, school-based skills-building programs, and changes to the built environment, yet these interventions are not sufficient on their own to achieve sustainable, population-level change on injury and violence outcomes. This problem has been characterized as the “research-to-practice gap.” Some have suggested there is a broad disconnect between the way we think about research and the way we need to think to make things happen at the population level. That is, have we failed to recognize that programs are embedded within larger systems, and that context is often the critical driver of health outcomes, including injury and violence? Are efforts to reduce injury and violence at the population level more likely to be effective when these efforts are focused not on encouraging the uptake of discrete countermeasures, but on changing the systems within which risk factors are embedded? Is the “next frontier” in injury prevention the realization that interventions can only influence population-level morbidity and mortality if incorporated into a larger effort that attends to the broader societal systems?

What conversation does the injury prevention community need to have?

This supplement of Injury Prevention features papers that provide a deeper dive into why attending to the broader systems and contexts in which injury and violence reside may be a critical paradigm shift for the field of injury prevention. This may include, for example, explicitly addressing factors such as building strong public demand for change, fostering committed societal leadership, developing and supporting appropriate infrastructure, investing in transdisciplinary coordination between all stakeholders (within and outside of public health), and catalyzing a strategic, long-term perspective among all of those involved. Injury prevention might have to look outside its field to identify additional approaches and methods for addressing the larger societal structures that drive injury and violence rates at the population level. There are many promising examples of such methods and approaches that can be adapted from fields such as population science.

What’s the vision for the future?

The supplement brings together empirically based examples of injury and violence prevention research that demonstrate state of the art methods of achieving population-level reductions in injury-related harm. Articles featured in the issue provide insight into ways in which moving beyond attending discreet injury and violence prevention interventions, and toward recognizing and addressing elements of the larger systems within which injury and violence are embedded, can result in impact at a population level.