The family physician’s role in preventing childhood injuries – Editorial
Juan G. Rodriguez
This issue of American Family Physician features an article by Deborah Glotzer, M.D., on one of the most important public health problems in the United States–childhood injuries. Since 1968, the death rate from all causes other than injury has declined 56 percent in children, while the death rate for injuries has declined only 25 percent. In 1986, intentional and unintentional injuries resulted in more than 22,000 deaths in infants and young people up to 10 years of age; among those aged one to 19 years, injuries accounted for 64 percent of all deaths. 
No other childhood condition causes as many lost years of life as injuries.  Each year, an estimated 600,000 children are hospitalized because of injuries, accounting for 20 percent of all hospitalizations among children (second only to respiratory illnesses).  Injuries lead to more hospital days of care than any childhood disease, cause the highest proportion of discharges to long-term care facilities and result in the highest proportion of children who require home health care after hospital discharge. Furthermore, almost 16 million children are seen for injuries in hospital emergency rooms each year. The estimated costs in 1985 for children who died because of injury amounted to more than $8 billion. 
Childhood injury and injury prevention have not received the attention they deserve from the medical community. Injury prevention has not been sufficiently integrated into medical curricula and has not received adequate research funding and support from the medical community. Traditionally, medical professionals have perceived injuries as “accidents” — unpredictable, unpreventable and merely a part of growing up. Injuries, however, like diseases, have associated risk factors, and knowledge of these predictable patterns can be helpful in nationwide prevention efforts.
Family physicians, who provide more ambulatory health care to Americans than any other specialists  and are well respected as a source of medical information, can help forge parental attitudes and influence general health practices. Injury prevention can easily be incorporated into routine prevention guidance, a mainstay of family practice. In one study,  appropriate injury counseling took only three minutes and 17 seconds of the physician’s time.
Several resources are available to help the physician become familiar with various issues in childhood injury prevention. [1,4,5] Additionally, such programs as The Injury Prevention Program of the American Academy of Pediatrics  provide packaged formats of developmentally appropriate interventions that can easily become part of the daily office routine.
The injury prevention challenge is clear, and the family physician, the first line of defense in our nation’s health care system, must take an active role in answering this challenge. Injuries are not random events. They are not inconsequential — and they can be prevented. The family physician’s commitment to this philosophy will go a long way toward improving the health of children.
JUAN G. RODRIGUEZ, M.D., M.P.H. MARK L. ROSENBERG, M.D., M.P.P. Division of Injury Control Centers for Disease Control Atlanta
 Division of Injury Control, Center for Environmental Health and Injury Control, Centers for Disease Control. Childhood injuries in the United States. Am J Dis Child 1990;144:627-46.
 McLemore T, DeLozier J. 1985 summary: national ambulatory medical care survey. Hyattsville, Md.: U.S. Department of Health and Human Services, 1987;no. (PHS)87-1250.
 Bass JL, Mehta KA, Ostrovsky M, Halperin SF. Educating parents about injury prevention. Pediatr Clin North Am 1985;32:233-42.
 Rodriguez JG. Childhood injuries in the United States: a priority issue [Editorial]. Am J Dis Child 1990;144:625-6.
 Rosenberg ML, Rodriguez JG, Chorba TL. Childhood injures: where we are. Pediatrics 1990;86(suppl):1084-91.
 The Committee on Injury and Poisoning Prevention. The Injury Prevention Program (TIPP). Elkgrove Village, Ill.: American Academy of Pediatrics, 1989.
COPYRIGHT 1991 American Academy of Family Physicians
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