WILTON L. Halverson, M.D., President of the American Public Health Association.
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OBJECTIVE: To describe current research in child and adolescent injury prevention by pediatric and public health investigators for comparison with national recommendations and agendas. DATA SOURCES: Abstracts submitted to the 1998 annual meetings of the Pediatric Academic Societies/Ambulatory Pediatrics Association and the American Public Health Association on injury or violence in children or adolescents. STUDY SELECTION: All abstracts of projects that addressed primarily injury or violence prevention involving children or adolescents. DATA EXTRACTION: For 123 abstracts, 2 coauthors extracted and classified age of the population, type of injury, study design, sizes of the sample and denominator, and type of outcome. RESULTS: Adolescents were the most frequent (49%) age group included. The investigations were concerned most with injuries caused by violence (33%), followed by motor vehicle trauma (14%) and burns (7%). Descriptive surveillance (38%), surveys (32%), and case series (13%) comprised the overwhelming majority of methods used. The studies primarily sought to identify risk factors for injury (32%), describe the victims (20%), or measure knowledge and/or practice (26%). Nine studies (7%) sought to measure the effect of interventions in some way, and only 2 focused primarily on methodology development. CONCLUSIONS: Injury prevention research projects presented at the 1998 Pediatric Academic Societies and American Public Health Association meetings were proportionate to the frequencies of injury by age and by external cause in the United States. However, in comparison with recommendations for agendas of national injury prevention research, more research is needed to improve injury prevention methods and to evaluate interventions.
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This paper discusses the American Public Health Association's goals with regards to the current health care reform debate. By outlining the organization's historical context with regards to health care reform as well as the parameters of the current medical care and public health crises, the paper explains why APHA's advocacy efforts focused on two major issues: the adoption of a national health program that features universal coverage with a comprehensive set of benefits for all our nation's residents, and the enhancement of the federal, state, and local public health infrastructure. The paper argues that both medical care services and public health programs must be expanded if we are to improve the nation's overall health status.
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