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Injury and Violence Prevention

Injury and Violence Prevention


Prevent unintentional injuries and violence, and reduce their consequences.


Injuries and violence are widespread in society. Both unintentional injuries and those caused by acts of violence are among the top 15 killers for Americans of all ages.1 Many people accept them as “accidents,” “acts of fate,” or as “part of life.” However, most events resulting in injury, disability, or death are predictable and preventable. The Injury and Violence Prevention objectives for 2020 represent a broad range of issues which, if adequately addressed, will improve the health of the Nation.2

Why Is Injury and Violence Prevention Important?

Injuries are the leading cause of death for Americans ages 1 to 44,1 and a leading cause of disability for all ages, regardless of sex, race/ethnicity, or socioeconomic status. More than 180,000 people die from injuries each year, and approximately 1 in 10 sustains a nonfatal injury serious enough to be treated in a hospital emergency department.1

Beyond their immediate health consequences, injuries and violence have a significant impact on the well-being of Americans by contributing to:

  • Premature death
  • Years of potential life lost
  • Disability and disability-adjusted life years lost
  • Poor mental health
  • High medical costs
  • Lost productivity3,4

The effects of injuries and violence extend beyond the injured person or victim of violence to family members, friends, coworkers, employers, and communities.

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Understanding Injury and Violence Prevention

Numerous determinants (factors) can affect the risk of unintentional injury and violence.

Individual behaviors

The choices people make about individual behaviors, such as alcohol and drug use, or risk-taking, are often connected with factors in the social and physical environment and can increase injuries.5,6

Physical environment

The physical environment, both in the home and community, can affect the rate of injuries related to falls, fires and burns, road traffic injuries, drowning, and violence.7,8,9

Access to Services

Access to health services, such as systems created for injury-related care, ranging from prehospital and acute care to rehabilitation, can reduce the consequences of injuries, including death and long-term disability.

Social Environment

The social environment has a notable influence on the risk for injury and violence through:

  • Individual social experiences (for example, social norms, education, victimization history)
  • Social relationships (for example, parental monitoring and supervision of youth, peer group associations, family interactions)
  • Community environment (for example, cohesion in schools, neighborhoods, and communities)
  • Societal-level factors (for example, cultural beliefs, attitudes, incentives and disincentives, laws and regulations)10

Interventions that address these social and physical factors have the potential to prevent unintentional injuries and violence. Efforts to prevent unintentional injury may focus on:

  • Modifications of the environment
  • Improvements in product safety
  • Legislation and enforcement
  • Education and behavior change
  • Technology and engineering11

Efforts to prevent violence may focus on:

  • Changing social norms about the acceptability of violence and the willingness to intervene 
  • Improving skills and competencies (for example, communication, impulse control, parenting, conflict resolution, coping)
  • Fostering safe, stable, nurturing relationships and environments for children and families
  • Changing policies to address the social and economic conditions that often give rise to violence

Emerging Issues in Injury and Violence Prevention

While not included as objectives in Healthy People 2020, there are several emerging issues in injury and violence prevention that need further research, analysis, and monitoring.

For unintentional injuries, there is a need to better understand the trends, causes, and prevention strategies for:

  • Prescription drug overdose deaths
  • Motor vehicle crashes due to distracted driving
  • Traumatic Brain Injury

In the area of violence, there is a need to better understand the trends, causes, and prevention strategies related to:

  • Bullying, dating violence, and sexual violence among youth
  • Elder maltreatment, particularly with respect to quantifying and understanding the problem
  • Overlapping causes of violence and the strategies that can prevent multiple forms of violence


1Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [Internet]; 2010 Mar 4 [cited 2010 Apr 1]. Available from:

2Sleet DA, Baldwin G, Marr A, Spivak H, Patterson S, Morrison C, Holmes W, Peeples A, Degutis L. History of Injury and Violence as Public Health Problems and Emergence of the National Center for Injury Prevention and Control at CDC.  Journal of Safety Research 43(4):233-248, 2012.

3Florence C, Simon T, Haegerich T, Luo F, & Zhou C. (2015). Estimated lifetime medical and work-loss costs of fatal injuries-United States, 2013. MMWR: Morbidity and mortality weekly report, 64(38), 1074-1077.

4Florence C, Haegerich T, Simon T, Zhou C, & Luo F. (2015). Estimated lifetime medical and work-loss costs of emergency department-treated nonfatal injuries-United States, 2013. MMWR: Morbidity and mortality weekly report, 64(38), 1078-1082.

5Bronfenbrenner U, & Bronfenbrenner U. (2009). The ecology of human development: Experiments by nature and design. Harvard university press.

6Haegerich TM, Dahlberg LL, Simon TR, Baldwin GT, Sleet DA, Greenspan AI, Degutis LC. Advancing injury and violence prevention in the United States. The Lancet. Vol 384(9937):64-74,July 5-11, 2014

7Mack K, Liller KD, Baldwin GT, Sleet DA. Preventing Unintentional Injuries in the Home Using the Health Impact Pyramid. Health Education and Behavior,  Vol. 42(1S) 115S–122S.  DOI: 10.1177/1090198114568306  2015.

8Doll LS, Bonzo SE, Mercy JA, et al., editors. Handbook of injury and violence prevention. New York: Springer; 2007. Chapter 14, Changing the built environment to prevent injury; p. 257-76.

9Brana CC, Cheney RA, MacDonald JM, Tam VW, Jackson TD, & Ten Have TR. (2011). A difference-in-differences analysis of health, safety, and greening vacant urban space. American Journal of Epidemiology, 174(11), 1296-1306.

10Mercy JA, Mack KA, Steenkamp M. Changing the social environment to prevent injuries. Chapter 15 in Handbook of injury and violence prevention (pp 277-94). Doll LS, Bonzo SE, Mercy JA, et al., editors. New York: Springer; 2007.

11Gielen AC, Sleet DA. Injury prevention and behavior: An evolving field. Chapter 1 in Injury and violence prevention: Behavioral science theories, methods, and applications (pp 1-16). Gielen AC, Sleet DA, DiClemente RJ, editors. San Francisco: Jossey-Bass; 2006.

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