ICRCs' research and practitioner training activities have been especially circumscribed because of curtailed funding.

Priority Areas for Future Research

To advance the injury field, the committee believes that NCIPC needs more resources for extramural research in selected areas. The committee predicated its selection of priority areas on the following criteria: the magnitude of the problem, trends in surveillance, gaps in knowledge, and the degree of support from other federal agencies. On the basis of the foregoing discussion in this chapter and in Chapter 4, the committee urges NCIPC to support an expanded research portfolio in the following areas: biomechanics, residential and recreational injuries, suicide prevention, and violence prevention.

The elucidation of more detailed research priorities within each of these general areas should be undertaken by NCIPC, in close coordination with its stakeholders and federal partners, through a systematic priority-setting process described later.

Biomechanics. Injury biomechanics is a seminal discipline for the study of injury causation (Chapter 4). Biomechanics reproduces patterns of injury under well-controlled laboratory conditions and examines structural and biologic responses. As noted above, NCIPC has provided consistent support for investigator-initiated research in injury biomechanics. This support must continue and should be expanded to ensure advances in our understanding of injury causation. Advances in biomechanics will be especially important in understanding nonfatal injuries that lead to long-term disability including brain injury and arthritis and are likely to lead to improved treatment. It is important to continue to expand the research effort in the study of injuries to the study of children, short women, and the elderly.

Residential and recreational injuries. Residential and recreational injuries are a serious problem. Although there appears to have been some decline in prevalence since 1985, more recent trends suggest a leveling off (Chapter 4). Within these broad trends are more alarming ones, such as apparent increases in unintentional poisonings (Fingerhut and Cox, 1998) and falls in the elderly. Mortality rates for falls in the elderly increased slightly from 1985 to 1995 (Fingerhut and Warner, 1997). Because such falls frequently lead to hospitalization, they represent a costly societal problem (Chapter 2).

It is incumbent on NCIPC to monitor surveillance trends in order to focus research on the most important problems related to residential and recreational injuries. NCIPC's support for these areas of research amounted to $7.5 million in FY 1997 (NCIPC Budget Office, personal communication, 1997). Apart from NCIPC, no other federal agency supports a research program in the prevention

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