and the utility of potential interventions. Many members of the general public as well as many policy makers still believe that injuries are "accidents" that just happen. This perception often precludes policy makers from identifying injury prevention as a discrete public health issue and limits the earmarking of federal and state dollars for injury research and for the development of prevention programs.

Raising Public Awareness

The breadth of the injury field has resulted in a number of advocacy and nonprofit organizations that generally focus on one type or cause of injury (e.g., BIA, MADD) or one population of concern (e.g., National SAFE KIDS Campaign). These organizations have a significant contribution to make to their issues of concern and to the broader field of injury prevention; together they can raise the visibility of injury prevention, build a broad base of support, and provide a recognizable constituency for the field of injury prevention and treatment. Policy makers' attitudes and interest in this field will not change easily without a change in society's attitudes and perception of the field. The field has to engage existing social marketing techniques to determine the messages that should be employed to raise the profile of injury prevention research and focus the public's and policy makers' attention on the preventability of injuries.

Advocacy

Public education, advocacy, and constituency building are key elements of modern public health practice at the state and community levels. Proactive "marketing" of public health is needed to arouse public awareness and concern, to counteract complacency or sluggishness, and to prod policy makers into action. The need for injury officials and program directors to embrace advocacy as a core professional role is a recurrent theme in the field (Rivara, 1997). According to the Institute of Medicine (IOM) report The Future of Public Health , educating legislators and political leaders "on public health issues and on the rationale for strategies advocated and pursued by the health department" is a key element of public health leadership (IOM, 1988). Eight years later, another IOM (1996, p. 39) committee noted:

Even when promising solutions exist, public health agencies too often have difficulty generating support for intervention among elected officials and the general public. A key struggle for [public health leaders] is making the benefits of community-based, population-wide public health activities and initiatives more recognizable, and finding allies who will speak on behalf of those initiatives and the unique role for government public health agencies in carrying [them] out. . . .



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