Ten Myths about Injury Prevention That Hinder Effective Child Safety Policy Making
Stone, David H., The Journal of the Royal Society for the Promotion of Health
Injury prevention researchers and practitioners are often deeply frustrated at the apparent lack of commitment at government level to the promotion of child safety. The gap between knowledge and action may seem at times to be a yawning chasm. The purpose of this article is to highlight ten myths that are so prevalent among professionals, civil servants and politicians that they should be regarded as major obstacles to progress in child safety policy making.
MYTH 1: THAT THE TERM 'ACCIDENT' IS A BARRIER TO PREVENTIVE ACTION
The reality. The old adage 'accidents will happen' is widely quoted as evidence of public ignorance about the nature of injury. The tendency on the part of the media and many professionals to use the word 'accident' allegedly reinforces the idea that safety is merely a matter of 'common sense' and that injury is therefore not particularly amenable to prevention. In consequence (so runs the argument), the continued use of such language perpetuates the idea that the vast majority of injuries are due to the irresponsible behaviour of either victims or, in the case of children, their carers. In fact, there is little or no evidence for such an assertion.1 On the contrary, research has demonstrated that, regardless of their preference for this or that terminology, the general public and even young children themselves2 have a rather sophisticated view of injuries and their causation and are well aware of the considerable potential for their prevention.
MYTH 2: THAT INJURY IS WIDELY RECOGNIZED AS A LEADING CAUSE OF DEATH AND ILL HEALTH IN CHILDHOOD IN ALL DEVELOPED COUNTRIES
The reality. National statistical agencies repeatedly publish data indicating that trauma is the largest single contributor to mortality in the first half of the human life cycle yet this fact is seldom acknowledged in official policy statements. In the UK, for example, a highly respected health analyst3 reviewed the current state of public health yet failed to identify injury explicitly as one of the leading causes of premature death in the population despite the inclusion in his report of data showing this clearly to be the case. Injury prevention nowadays rarely features as a main health priority in UK government health policy statements.
MYTH 3: THAT PUBLIC HEALTH AGENCIES IN MOST COUNTRIES HOLD REASONABLE QUALITY DATA ON THE INCIDENCE AND CONSEQUENCES OF CHILDHOOD INJURY.
The reality. Most developed countries have access to detailed data on the pattern of mortality and sometimes healthcare presentations (usually hospital admissions) of patients with injury. Yet even countries with extensive health databases know very little about the key epidemiological indicator of incidence4 and even less about the underlying causes, circumstances or mechanisms of injury. Virtually no routine data are available on the long-term consequences of injury for the physical and emotional health of victims, or the impact it has on families, communities and society as a whole.
MYTH 4: THAT THE INCIDENCE OF UNINTENTIONAL INJURY HAS BEEN DECLINING IN MOST WESTERN COUNTRIES DUE TO THE IMPLEMENTATION OF COUNTERMEASURES
The reality. Mortality from unintentional injury in children appears to have declined in recent decades but we have little information on incidence (see Myth 3). Declining injury mortality may reflect improving case-fatality rates in victims due to better quality trauma care5 rather than declining incidence. A reasonable assumption is that a cluster of countermeasures - such as car seat belts, drink driving laws, child resistant containers and fire-proof nightwear - have contributed to the observed fall in injury mortality, but the empirical data are inadequate to draw firm conclusions. Other possible explanations for declining child injury mortality include reduced exposure to hazards (e.g. children being taken by car rather than walking to school), and changing recording and classification practices (e. …