Injury Prevention for Children and Adolescents: Research, Practice, and Advocacy

Injuries are “one of the most under-recognized public health problems facing the world today,” as described in the prologue of the second edition of Injury Prevention for Children and Adolescents: Research, Practice, and Advocacy. Here the book’s editor, Karen D. Liller, PhD, discusses some important considerations when it comes to injury among children and youth. She is dean of the University of South Florida Graduate School and associate vice president for research and innovation as well as a professor in the USF College of Public Health specializing in public health and children’s injury prevention and a professor of orthopedics and sports medicine at the USF College of Medicine. Her research has explored many areas of injury prevention and control, especially among youth, and she has been an APHA member since 1988.

In the book you explore the cost of child and adolescent injuries and the savings from prevention. How does this contribute to the national conversation on the importance of prevention in health and health care?

As stated in the chapter by Miller, et al., “child and adolescent injuries in 2000 resulted in an estimated $24 billion in lifetime medical spending and $82 billion in present and future work losses, including caregiver losses. These injuries killed approximately 18,000 children and left approximately 160,000 children and adolescents with permanent work related disabilities.”  These are huge numbers, and various prevention strategies can go a long way toward greatly decreasing these needless injuries and deaths and related costs.  This does contribute to the important national conversation on prevention in health and health care.  It has been reported health care costs in the United States will be over $4 trillion in 2019!  To decrease these costs, injury prevention must be in the mix not only in terms of costs but what they rob our society.  Injuries lead in producing the greatest years of potential life lost since so many children and adolescents are affected.  We lose the future with these injuries, and this is devastating.

I noticed a mention of your two children in the book’s dedication. How does being a mother contribute to your passion as a public health professional?

I am so glad you asked this question.  When I first started to research injuries I did not have my children, but after having Matthew and Rebecca, my passion for public health and injury prevention especially grew exponentially!  It is very important that public health professionals never lose sight of the fact that their work is more than about numbers or cases, but about real people with real lives.  Seeing my own children grow and develop has allowed me to see “faces” every day and really why I do this work.  If I can make just one child safer and help prevent a needless injury, then I have done what I set out to do.  But what is wonderful about public health is that our strategies go way beyond individuals as they are population-based so our reach can be very broad.  My children show me the future and how important it is to protect those individuals who are not ready to protect themselves.

The second edition of Injury Prevention for Children and Adolescents includes two new chapters, one on global injuries and another on translational research related to child and adolescent injury. Why are these important topics?

These chapters are very important as our future in injury prevention, I believe, is global, and the importance of being able to translate our findings into practice is paramount — and we cannot wait longer for this to be a reality.  While we have made great strides nationally in child and adolescent injury prevention, we must now also turn our attention globally.  In fact, most injuries occur in developing countries.  What makes this especially challenging is that the strategies we have developed for prevention in the United States do not necessarily translate to effective interventions globally.  So we must assess the needs and work with global communities in designing targeted and appropriate interventions.  As for translation of research, we must be able to translate our findings so that research findings can reach our communities successfully.  We must strategically be able to get our message across so that our findings are successfully disseminated much more timely and our reach is greater. �

What role should public health professionals play in injury prevention, especially for children and adolescents?Public health professionals have a crucial role in preventing injuries among children and adolescents.  Health professionals, such as pediatricians, have a great opportunity to reach children and parents with injury prevention messages. Research shows that prevention strategies led by these health professionals can be successful.  Other public health professionals, as well as educators and other individuals and groups who work with children, need to be advocates for children’s injury prevention.  Whether it be through advocating for children riding safely in cars, to safe practices in the home and workplace, to supporting graduated licensing, and more, the messages should be there consistently.  But education alone is not enough.  Public health professionals need to support engineering and environmental changes as well so children’s injury prevention follows a holistic path.  Parents and children and adolescents must hear the messages consistently and see evidence of their success if we are to make progress in saving lives.

What do you see as the greatest opportunities for preventing injury among our youth, and what are some of the challenges that lie ahead in the future of childhood and adolescent injury prevention?

I see many opportunities for preventing injury among children and youth.  We have come very far in several areas, and there are many opportunities to continue our success in motor vehicle injury prevention and other injury areas.  We need to continue to support booster seats for children and graduated licensing for adolescents, along with supporting successful injury prevention strategies focused on the home, work, schools, recreation and sports, agriculture, firearms, violence and more.  We need to better understand what is effective supervision of children as supervision is key to so many prevention strategies.  We also have opportunities to support better product designs and safer environmental settings.  We have opportunities to help prevent child abuse, neglect and firearm violence.  We have an opportunity to continue to build a “culture of safety” and cannot stop the momentum.  We also face many challenges.  Some examples include driver distractions (texting, talking on the phone, etc., while driving), court rulings on the second amendment, and what I think is a great challenge is the rise in poisoning deaths.  The problems with prescription drug abuse will be challenging and will need the concerted efforts of the entire public health community to decrease deaths and injuries.  We also face challenges with funding for our efforts.  Without funding and other resources, many of our proven strategies will not be implemented.  We must educate our policy makers and legislators about the cost-saving measures of injury prevention so that our efforts can be preserved and enhanced.  It is our hope that then children and adolescents not face needless injuries and untimely and tragic deaths.

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