History of Injury EpidemiologyThomas Songer, PhDUniversity of PittsburghCenter for Injury Research & ControlMoving Towards Competency in Injury PreventionHistory forms the basis for many of the decisions and actions in epidemiology. Much of the current research in injury epidemiology is heavily influenced by the events of the past. This lecture provides a brief overview of the themes that shaped injury research and injury control efforts over the last 100 years.For those with a serious interest in this topic area, more information can be found from the following sources:1. Accidents in History; injuries, fatalities, and social relations. Cooter, Luckin (eds). Rodopi, Amsterdam, 1997.2. Waller JA. Reflections on a half century of injury control. Amer J Public Health 84:664-70, 1994.3. National Safety Council’s Safety & Health International Hall of Fame. In http://www.nsc.org/shhofi.htm4. Overview of Landmark Injury Prevention Events in the United States, 1937-1997. In Injury Prevention and Public Health. Christoffel, Scavo Gallagher (eds). Aspen Publishing, Gaithersburg, MD, 1999.5. Rockett IRH. Injury and Violence; a public health perspective. Volume 53, No. 4 (Washington, DC: Population Reference Bureau, Dec 1998.)Lecture Objectives1. Identify the themes which have shaped the development of injury epidemiology2. Describe how the perception of injury by the professional community has changed over time3. Describe the biomechanics which underlie how injury occurs4. Illustrate Haddon’s ten principles of limiting energy transferOn completion of this lecture, …you as a reader and listener should be able to:Lecture Objectives5. Describe the difference between active and passive forms of intervention in the injury context.On completion of this lecture, …you as a reader and listener should be able to:Core Competencies for Injury and Violence Preventionwww.injuryed.orgCore Competency #1:Ability to describe and explain injury and/or violence as a major social and health problem.This lecture is one part of a concerted effort to provide more training to persons interested in injury and violence prevention. The lecture was written with the core competencies for injury and violence prevention in mind. More specifically, the lecture objectives were selected to address the first core competency, as outlined in this slide.Further details on this and the other core competencies can be found at the following reference:Songer TJ, Stephens-Stidham S, Peek-Asa C, Bou-Saada I, Hunter W, Lindemer K, Runyan C. Core Competencies for Injury and Violence Prevention. American Journal of Public Health 99(4):600-606, 2009. Available online at www.injuryed.org.Themes Shaping the Study of Injury@1900 - 2005Themes Shaping the Study of Injuries• Shaped by technology• Shaped by industry• Spurred by research on biomechanics• Shaped by history of epidemiology• Heavily influenced by Haddon• Shaped by recent successThe themes addressed in this lecture will focus on the areas of technologies and accidents, industrial perspectives to accidents, that natural evolution of epidemiology and it’s meaning for injury research, the dynamics learned from biomechanics research, and the ground-breaking work of William Haddon, Jr..Injury research, in essence, is also relatively new. While injury prevention interventions have been around for centuries, the application of scientific methods to injury control did not occur with any substance until the late 1960s. Thus, the framework for this presentation primarily represents the developments in the last century. Particular emphasis is placed on the role of the injury research with respect to the automobile.Injury research has been shaped by technologyThe first item for discussion is the view that injury research has been shaped by our responses to and introduction of new technologies. For example, since the early ages of mankind, technologies have been developed to protect against injury in warfare (e.g. body armor). The industrial revolution and the advent of automatic machinery appears to be a watershed event in the injury realm. Prior to this time, most work was agriculturally oriented. The industrial revolution led to urbanization and the development of factories. The injury risk in this environment increased significantly to the extent that accidents and injuries became an accepted part of ordinary life. Both business and the state accentuated the “normalization of the accident” (Luckin). This means that industry and government accepted that injuries were part of the cost of doing business. Injuries and accidents were one of the consequences of economic development. This perspective is an ongoing issue in the developing countries of the world even today.This business and government laissez faire approach to safety set the stage for the events of the 20th century, and our initial attitude to the automobile.The Automobile1900 - 2000Historically, one can view the last 100 years as the century of the automobile. The automobile has dramatically changed the way in which we live our lives. Mobility is much greater now than in any time in the past. There are consequences to this discovery as well. A significant portion of air pollution is attributed to motor vehicles, and traffic-related fatalities are now a large part of life.The International Red Cross, in the World Disaster Report, has characterized the last 100 years as the “Century of road death”. The first pedestrian death was noted in 1896 and the first driver died in a crash in 1898. The dangers of the automobile and road traffic accidents were regularly featured in the Lancet in the beginning of the 20th century.Source: International Federation of Red Cross and Red Crescent Societies. World Disaster Report, 1998. Oxford University Press, Oxford 1998.Road Traffic Accidents. Lancet 352:1483, Oct 31 1998.Top Ten Public Health AchievementIn the developed world, though, the impact of road traffic accidents has been continuously improving. Indeed, the reduction in the rate of death attributable to motor-vehicle crashes has been called one of the most successful public health responses to a great technologic advance of the 20th century--the motorization of America. Six times as many people drive today as in 1925, and the number of motor vehicles in the country has increased 11-fold since then to approximately 215 million. The number of miles traveled in motor