Injuries and Accidents: Psychosocial Aspects

Everybody is at risk for incurring an injury, although some individuals or populations may have greater risk than others. Injuries are consistently among the contributors to disabilities and death, lost years of productivity and potential life at all ages, resulting in incalculable costs and pain to victims and families around the world. Among the leading causes of injury are the categories of motor vehicle passenger and pedestrian, drowning, poisoning, falls, firearms, and suffocation. Social scientists from disciplines of psychology, public health, and sociology, among others, emphasize the term ‘unintentional injuries’ because the historical and layperson use of the term ‘accidental injury’ implies the effect of uncontrollable chance, fate, or other capricious events that cannot be avoided. Professionals now believe that the circumstances resulting in injuries can be subjected to scientific study, and therefore injury outcomes are thought to be explicable and preventable. Professionals studying injuries utilize several empirical methodologies to gain an understanding of the precursors to an injurious event, of the nature or circumstances of the event itself, and of the aftermath or consequences of an injury. The epidemiological method relies on population-wide statistics about the prevalence and incidence of injuries. Psychologists often utilize techniques of behavior analysis to study the antecedent—behavior—consequences sequential chain of events to determine how injuries are produced. Research into personality traits has not consistently identified an ‘accident prone’ type. Injury control (prevention of injury) seeks to avoid the occurrence of a potential injury by changing the conditions and the behavior leading to injury, or by reducing the degree of damage when an event occurs. Injury prevention or control can take place through several different types of overlapping interventions. Structural interventions are those that modify the environment in order to change potential hazards so that people do not encounter them (e.g., fence barriers keep people out of swimming pools, abandoned mines, and quarries; and child-proof caps on medicine bottles keep children from potential poisons). Behaviorally-based approaches typically involve active prevention measures in which individuals take action on their own behalf or for others in order to achieve protection. Deficient safety behaviors or excessive unsafe behaviors can be changed so that the injury-producing sequence is altered (e.g., rewards for riding secured in car safety seats or seat belts). Much of the injury prevention effort in many countries has been devoted to providing information (health education) to parents to change their child's environment to be safer or for adults to be safer in work or recreation. This information provision may take place through lectures, pamphlets, or brochures about such things as securing storage of poisons above children's reach and safe lifting practices in adults' workplaces. Community-based interventions are made to change the attitudes and behavior of whole communities with mixed evidence of effectiveness depending on the types of programs implemented. Fragmented injury prevention programs, all too often lacking in evidence of effectiveness, are the norm. A combination of scientific methodologies is needed to gain a comprehensive view of injury causes and possible prevention/control strategies. Despite the pervasiveness of injuries, professionals frequently note the lack of social outrage to motivate comprehensive injury control efforts. In all countries and on all continents in the world injuries remain an enormous societal and scientific issue for research and development of preventive interventions. Social science contributions continue to be made as methodology is applied to gain a better understanding of injury events and causes as well as to empirically evaluate the effectiveness of interventions to prevent or control injuries.