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Reducing the Burden of Injury: Advancing Prevention and Treatment
prevention and treatment communities were to lose their sense of common identity. Injury epidemiology straddles prevention and treatment, serving as a bridge and source of information and insight in both directions. Designing strategies for protecting people from the effects of injury-causing events requires ongoing scientific communication between scientists in biomechanics, molecular biology, and clinical pathology. Implementation of public education and other prevention programs requires participation of surgeons and rehabilitation specialists to convey information about consequences. Although the task of drawing together specialists in injury prevention and treatment is unfinished, remarkable progress has been made.
A recent example is the Crash Injury Research and Engineering Network (CIREN) established by NHTSA in 1996. CIREN links trauma center clinicians and crash investigators in a nationwide computerized network. This enables engineers to better understand injury-producing mechanisms and to develop better criteria for vehicle safety design, while informing clinicians about emerging injury patterns, and thereby facilitating triage, diagnosis, and treatment of crash injuries.
Of course, not all people interested in preventing or treating injuries (e.g., violence and suicide prevention, highway engineering, fire safety, emergency medical services) identify themselves with the injury field. All of these groups have an interest in safety, which is more a common cause than a recognizable field of scientific study or professional practice. However, many people within these specialized spheres have increasingly recognized their common interests with specialists in the injury field and have embraced its conceptual paradigms, intellectual perspectives, and methods. One of the challenges facing the field in the coming years is to develop and implement strategies for injecting injury science into the training curricula of the many disciplines that participate in and contribute to the injury field.
The injury field (including the many specialized spheres of interest within it) overlaps with other fields whose knowledge and practice affect injury prevention and treatment. These adjacent fields include substance abuse, disability prevention, criminal justice, child development, and mental health. Another important challenge facing leaders of the injury field in the coming years is to facilitate collaboration with scientists and practitioners from these many overlapping and adjacent fields.
A vibrant interdisciplinary field, encompassing biomedical, engineering, and social and behavioral sciences cannot thrive in the face of intellectual orthodoxy. In the injury field, the challenge has been to open a discourse between environmental and behavioral perspectives. Until the 1960s, the predecessor field of accident prevention was dominated by a behavioral perspective, and proposed