Our mission is to reduce the number of injuries and deaths due to injuries, 
through prevention, improved trauma care, and improved rehabilitation.

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Trauma Foundation
SF General Hospital
Bldg 1 Rm 300
San Francisco, CA 94110
Fax: 415/821-8202
email: tf@tf.org

At a time when economists predict double-digit increases in health care expenditures, I have a solution: injury prevention. At a time when we are looking for ways to address disparities in health care, I have a solution: injury prevention. At a time when we are looking for ways to protect our children from harm, I have a solution: injury prevention. The next time someone challenges us on the propriety of addressing injury as a public health problem, point out that if something kills people, it's our responsibility as public health leaders to find a solution."
-- Georges C. Benjamin, MD, FACP, Exec Director APHA (AJPH 4/2004 94(4))







April 22,  2004



The Burden of Injuries in America

One of our recent home pages addressed the daunting tragedy of war-related civilian injuries in Iraq. We would now like to focus on a significant problem in our own country, on our streets, in our homes, in our backyards. It is the unrecognized, costly, and painful "burden of injuries" here in the United States.

Ask Americans what the leading causes of death or health problems are in the United States, and they are likely to tell you cancer, heart disease, obesity, smoking. Most would not include injuries in this list; most might not even think of injuries as a category in its own right, not to mention a leading cause of death and disability. 

Yet the facts are that injury is indeed among the leading causes of death. In fact, injuries are the leading cause of death for those under 35 years of age and the fourth leading cause across all age groups. Injuries exact a high toll on our society, causing pain and suffering for friends, family, and caregivers, as well as losses in productivity. In addition, injuries cost billions of dollars for medical treatment and rehabilitation. 

A recent Morbidity and Mortality Weekly Report (MMWR Jan 16, 2004/53(01);1-4) noted that:

  • injury-attributable medical expenditures cost as much as $117 billion in 2000, approximately 10% of total U.S. medical expenditures.

Reports from the Centers for Disease Control and Prevention reveal that similar expenditures:

  • for cancer were $60 billion in 2002.
  • for heart disease and stroke are projected to be $209 billion in 2003.

Yet funding for injury prevention and research is woefully lacking. For example, The Centers for Disease Control and Prevention received a $7.1 billion dollar funding level for fiscal year 2004. Of that, 

  • chronic disease prevention (addressing such health concerns as diabetes, cancer, and heart disease) received $853 million 
  • while injury prevention received just $154 million

Unlike for other diseases and health problems, there is no institute for traumatic injury, and as such no approximation of the level of funding for research and prevention for injury as there is for other health issues. In fact, it is difficult to determine the current level of funding for traumatic injury-related death and injury since various institutes, such as the National Institutes of Health (NIH), do not specifically identify injury-related issues. Even NIH, in its current "Estimates of Funding for Various Diseases, Conditions, research Areas" does not list traumatic injury as a research or disease area.

Clearly, injuries deserve increased federal attention backed up by adequate funding, so that public health advocates and professionals can do the work of: 

  • defining the problem
  • identifying risk and protective factors
  • developing and testing prevention strategies
  • assuring the widespread adoption of effective prevention strategies.

In an environment of shrinking budgets and the erosion of public and nonprofit safety nets, preventing costly injuries and the pain and suffering they cause makes sense for the short and long term.

References & Resources
10 Leading Causes of Death--from The Injury Fact Book 2001-2002 Centers for Disease Control and Prevention, 

CDC, FY 2004 CDC/ATSDR Appropriation Fact Sheet, Jan. 23, 2004 

Preventing Heart Disease and Stroke, CDC 

Cancer Control, CDC 

Trauma Foundation's Index to Injury Prevention web sites


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