and state and federal agencies) with the common goal of reducing injury morbidity and mortality and promoting highway safety.

Local, state, and federal leadership and collaboration is also needed to support poison control centers. Poison control centers coordinate care for poison victims from the point of exposure to information sources and therapies, as well as serving as a locus for prevention, training, and research on poisoning. The number of poison control centers in the United States has declined steadily over the past two decades and is currently precariously low (Litovitz et al., 1994). Currently, many poison control centers face serious funding constraints while others face closure, and no one federal agency is responsible for sponsorship (Poison Control Center Advisory Work Group, 1996). Yet, it has been estimated that poison control centers prevent an estimated 50,000 hospitalizations and 400,000 doctors' visits annually (Poison Control Center Advisory Work Group, 1996). The committee urges federal leadership in supporting and sustaining poison control centers in the United States.

Coalition Building

At the community level, injury prevention becomes the responsibility of numerous organizations and agencies. Day-care facilities, nursing homes, schools, police and fire departments, civic organizations, athletic leagues, families, and numerous other groups all implement measures to prevent or minimize injuries. As a result of this diverse group of stakeholders, coalitions have been found to be particularly useful as a means of pooling resources, targeting specific injury problems, and educating the interested parties on effective injury prevention interventions (National Committee, 1989).

Injury prevention coalitions range in the degree of formality and the breadth of their mission and activities. Grassroots coalitions have been started by concerned parents, health professionals, and other individuals. For example, the San Francisco Bay Area Coalition on Drowning Prevention advocated for a change in county ordinances to require safety measures for backyard pools (National Committee, 1989). Other coalitions are nationwide efforts and include the National SAFE KIDS Campaign which works through more than 240 state and local coalitions to promote children's safety efforts (SAFE KIDS, 1998a). Safe Communities, a program initiated by NHTSA, strives to reduce traffic safety injuries by working at the community level through broad coalitions of public safety officials, medical services providers, civic and industry leaders, and citizens (NHTSA, 1998; see Chapter 8).

Since injury prevention is often most successful at the local level, where specific injury problems can be addressed, coalition building is crucial to strengthening the nation's response to the injury problem. Financial and technical assistance is needed from federal and state government agencies and from the private for-profit and nonprofit sectors.



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