by Susan Muaddi Darraj
Illustration by Kirk Caldwell
Cabinet locks hinder easy access to medicines and toxic cleaning products in the bathroom. In the kitchen, knob covers on the stove prevent children from burning themselves. Wall anchors ensure that heavy bookshelves and dressers will not fall on toddlers trying to climb them. Stairway gates prevent a child from falling.
As conceived by the Center for Injury Research and Policy (CIRP), the Mobile Safety Center—essentially, a small house on a 40-foot-long tractor-trailer—allows parents to walk through various rooms, learn about injury prevention methods, test the many safety products, such as cabinet locks and smoke alarms, and purchase them at a discounted price. Parents and children can even practice crawling out of a smoke-filled bedroom in case they are ever caught in a real-life fire. (A machine fills one room with smoke while a heating device heats up the door—all to emphasize the importance of developing a fire emergency escape route.) The Mobile Safety Center is expected to be on the road and bringing injury prevention strategies to Baltimore in the fall of 2003.
The rolling instructional facility is just the latest injury prevention initiative by the CIRP. Since 1987, the Center has had a single mandate: to reduce injuries.
Claiming more years of productive life in the United States than any other cause, injuries kill more children, adolescents, and teenagers than all diseases combined. They are the leading cause of death for people 44 years old and younger. Almost one in four Americans sustains an injury every year, and more than 150,000 die each year from injuries.
"These are chilling statistics by any metric," says Ellen MacKenzie, PhD '79, MSc '75, director of the Center and professor in the Department of Health Policy and Management. "But history has taught us that we can have an impact on these numbers." Founded by Professor Susan Baker, MPH '68, the Center has employed a public health approach to identify injury risk factors, and then to design, implement, and evaluate prevention and rehabilitation programs.
CIRP faculty have shaped much of what we know about injuries in this country. Baker essentially defined the field, doing groundbreaking research in motor vehicle occupant and pedestrian deaths, aviation fatalities, and occupational injuries. MacKenzie co-authored Cost of Injury, a 1989 report to Congress that estimated the financial burden of injury in the United States at $160 billion. The report is now a standard reference on the topic.
Faculty from the Center have also conducted extensive research on the relationship between alcohol and injury, highlighting drinking patterns as a predictor of injury. They were among the first to examine deaths caused by firearms as a public health problem, and have actively been advocating safer gun designs and evaluating existing gun laws.
The accomplishments of the Center and other injury prevention researchers in the region were celebrated at a June 20 conference in Baltimore that marked the 10th anniversary of the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention. During the conference, participants inspected a tabletop prototype and video of the Mobile Safety Center and honored Susan Baker for her work in the field.
"Because injuries and violence historically were not considered public health problems, the field of injury prevention is a relatively young one. Nevertheless, we have learned a great deal about how to prevent many of the leading killers by using the public health approach," says Andrea Gielen, ScD '89, ScM '79. "One challenge for the future is to find ways to disseminate this life-saving knowledge and technology so that all segments of the population are equally protected."
The following images illustrate the world of injury prevention and offer a snapshot of the Center's studies and policy initiatives....
Figure 1. Centers for Disease Control and Prevention. A 2001 CIRP study found poisonous substances in unlocked places in 93% of homes observed in East Baltimore.
Figure 2. U.S. Consumer Product Safety Commission, 2001. CIRP faculty are developing a model playground safety law.
Figure 3. 2002 CIRP study. The Children's Safety Center sells smoke alarms at discounted prices to families.
Figure 4. 1998 CIRP study. Skate-boarding injuries were 8 times more likely to be severe than roller skating injuries.
Figure 5. 1995 CIRP study. Research on the nation's first bicycle helmet law showed that helmet usage rates can be tripled by legislation and education.
Figure 6. 2000 CIRP study. 16- and 17-year-old drivers have a greater chance of dying in car accidents when accompanied by passengers.
Figure 7. National Highway Traffic Safety Administration. The Children's Safety Center has provided 400 car safety seats to low-income families.
Figure 8. 2001 CIRP study.
Figure 9. 1995 CIRP study. The research also found that driver's license renewal laws involving vision and knowledge testing were related to a lower risk of fatal crashes.