A national, long-term commitment to the expansion of training and interdisciplinary research in injury prevention is essential to public health. Without this commitment, injury research will not achieve the sophistication necessary for effective intervention development; talented new researchers will not be attracted to the field; and existing injury researchers may be forced to leave the field. In short, without a national commitment, the field of injury science will stagnate and the unnecessary toll of injury will persist.

CASE STUDIES ON PREVENTION

The two leading mechanisms causing fatal injury in the United States are motor vehicles and firearms; in 1995, 42,452 people died from motor vehicle traffic injuries and 35,957 people died as a result of firearm injuries (Fingerhut and Warner, 1997). Over the past three decades, dramatic progress has been made in reducing motor vehicle injuries by understanding the factors that increase the risk of injury; designing interventions to reduce these risks; implementing and evaluating a wide array of interventions; assessing their benefits and costs; and providing a scientific foundation for individual and business choices and public policy judgments. However, a similar comprehensive multidisciplinary approach has not been taken in relation to firearm injuries.

Over the long term, an effective national policy directed at reducing the risk and severity of firearm-related injury requires a strong federal presence. The multipronged approach used to develop federal motor vehicle safety policy—surveillance, regulatory action, multidisciplinary research, support for state and local prevention initiatives, and public support—provides a useful model.

The committee recommends the implementation of a comprehensive approach for preventing and reducing firearm injuries that includes firearm surveillance, firearm safety regulation, multidisciplinary research, enforcement of existing restrictions on access by minors and other unlawful purchasers, prevention programs at the state and local levels, and mobilization of public support.

A workable political consensus has not yet developed on the balance that should be struck between the prerogatives of firearm ownership and the reduction of firearm-related injuries, especially in a social context in which about 192 million firearms, including 65 million handguns, are in circulation (Cook and Ludwig, 1996). In the committee's view, a workable consensus is most likely to emerge if the discussion is focused less on ownership issues and more on the steps that can be taken to reduce the adverse health consequences of firearms use and to strengthen the scientific basis of policy making. In short, the points of departure for national firearms policy should be harm reduction and better science.



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