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Reducing the Burden of Injury: Advancing Prevention and Treatment
The Mission and the Boundaries of the Injury Field
The mission of the injury field is prevention, amelioration, and treatment of injury and the reduction of injury-related disability and death. The field is defined by its focus on the injury, whatever the mechanism by which it was immediately caused and regardless of the contributing role of human intent. This understanding, which emerges clearly from Injury in America (NRC, 1985), has profoundly important implications for the boundaries of the field because, by drawing no distinction between unintentional and intentional injuries (i.e., homicide, assaultive injuries), it broadens the reach of prevention research and practice beyond the traditional domain of "accident prevention."
Despite its emphasis on the need for greater attention to assaultive and self-inflicted injuries, Injury in America focused mainly on unintentional injuries, primarily those caused by motor vehicle crashes. Three years later [with the publication of Injury Control; (NRC, 1988)], the IOM reviewed the status and progress of the injury control programs at the Centers for Disease Control and Prevention (CDC); that report reiterated the need to intensify the study of intentional injury.
The committee decided, unanimously, to reaffirm the views expressed in Injury in America and Injury Control regarding the scope and mission of the injury field. Despite important differences associated with intentionality, the committee strongly endorses the continued integration of all injury prevention activities within a common framework of research and program development. The injury field has much to contribute to scientific understanding of firearm injuries and to the prevention of violence, complementing the contributions made by criminal justice, mental health, and other approaches. The public health investment in these areas should be strengthened, not abandoned or diminished.
The committee notes that there have been major accomplishments in the injury field over the past 25 years. Future advancements are dependent on the continued development and support of the infrastructure of the field. Investment in priority areas (discussed below) will ensure further advances in injury science and practice.
Improving coordination and collaboration: Coordinating the diverse efforts currently devoted to injury prevention and treatment, promoting collaboration among interested agencies and constituencies, and clarifying the roles of the main federal agencies.
Strengthening capacity for research and practice: Strengthening the infrastructure of the injury field for developing knowledge and for translating knowledge into practice.
Integrating the field: Infusing the injury field with a common sense of purpose and a shared understanding of its methods and perspectives, and promoting new channels of communication.