David A Sleet

• Ph.D., MA, FAAHB
• Managing Director at Centers for Disease Control and Prevention

Introduction: Despite 49 states and the District of Columbia having seat belt laws that permit either primary or secondary enforcement, nearly half of persons who die in passenger vehicle crashes in the United States are unbelted. Monitoring seat belt use is important for measuring the effectiveness of strategies to increase belt use. Objective:...

Context Motorcycle crashes account for a disproportionate number of motor vehicle deaths and injuries in the U.S. Motorcycle helmet use can lead to an estimated 42% reduction in risk for fatal injuries and a 69% reduction in risk for head injuries. However, helmet use in the U.S. has been declining and was at 60% in 2013. The current review examine...

Among Americans aged 65 years and older, falls are the leading cause of injury death and disability, and finding effective methods to prevent older adult falls has become a public health priority. While research has identified effective interventions delivered in community and clinical settings, persuading older adults to adopt these interventions...

Traumatic brain injury (TBI) can have long term effects on mental and physical health, and can disrupt vocational, educational, and social functioning. TBIs can range from mild to severe and their effects can last many years after the initial injury. CDC seeks to reduce the burden of TBI from unintentional injuries through a focus on primary preven...

Injuries continue to be the leading cause of death for the first four decades of life. These injuries result from a confluence of behavioral, physical, structural, environmental, and social factors. Taken together, these illustrate the importance of taking a broad and multileveled approach to injury prevention. Using examples from fall, fire, scald...

Objective: Efforts to promote environmental designs that facilitate opportunities for physical activity should consider the fact that injuries are the leading cause of death for Americans ages 1 to 44, with transportation-related injuries the most common cause. Drawing on the latest research and best practices in the field of injury prevention, th...

In the first three decades of life, more individuals in the USA die from injuries and violence than from any other cause. Millions more people survive and are left with physical, emotional, and financial problems. Injuries and violence are not accidents; they are preventable. Prevention has a strong scientific foundation, yet efforts are not fully...

Publicized sobriety checkpoint programs deter alcohol-impaired driving by stopping drivers systematically to assess their alcohol impairment. Sobriety checkpoints were recommended in 2001 by the Community Preventive Services Task Force for reducing alcohol-impaired driving, based on strong evidence of effectiveness. Since the 2001 review, attention...

IntroductionA major health threat facing young people today is unintentional injury. High-risk behaviors contributing to injury continue to threaten the health and the quality of life during adolescence, defined here as ages 10 through 19. In fact, more adolescents in the United States die from injuries than from all other causes of death combined...

This case study of the Argentina Road Safety Project demonstrates how the application of World Bank road safety project guidelines focused on institution building can accelerate knowledge transfer, scale up investment and improve the focus on results. The case study highlights road safety as a development priority and outlines World Bank initiative...

Objectives: After driving, walking is older adults' second most preferred mode of transport and preferred recreational activity. This leads to greater exposure to traffic, increasing their risk of pedestrian-vehicle crashes, with older adults being more likely to die as a pedestrian compared to when using other modes of transport. However, less fo...

Importance: Understanding the major health problems in the United States and how they are changing over time is critical for informing national health policy. Objectives: To measure the burden of diseases, injuries, and leading risk factors in the United States from 1990 to 2010 and to compare these measurements with those of the 34 countries in th...

Introduction: Quantifying years of potential life lost (YPLL) highlights childhood causes of mortality and provides a simple method to identify important causes of premature death. Methods: CDC analyzed data from the National Vital Statistics System multiple cause of death files for 2000-2009. Results: An average of 890YPLL were lost each year...

Motorcycle fatalities are increasing at an alarming rate in many South-East Asian countries, including Cambodia. Through brief face-to-face roadside interviews in Phnom Penh and four other Cambodian provinces, this article assesses Cambodian motorcyclists' attitudes, behaviours and beliefs related to motorcycle helmets. Out of 1016 motorcyclists in...

Morbidity and Mortality Weekly Report MMWR. 2012;41:830-833. 2 tables omitted. Available at http://www.cdc.gov/mmwr/PDF/wk/mm6141.pdf. Unintentional injuries are the leading cause of deaths among persons aged 0-19 years in the United States. Quantifying years of potential life lost (YPLL) highlights childhood causes of mortality and provides a simp...

Background: Non-fatal health outcomes from diseases and injuries are a crucial consideration in the promotion and monitoring of individual and population health. The Global Burden of Disease (GBD) studies done in 1990 and 2000 have been the only studies to quantify non-fatal health outcomes across an exhaustive set of disorders at the global and re...

Background: Measuring disease and injury burden in populations requires a composite metric that captures both premature mortality and the prevalence and severity of ill-health. The 1990 Global Burden of Disease study proposed disability-adjusted life years (DALYs) to measure disease burden. No comprehensive update of disease burden worldwide incorp...

Quantification of the disease burden caused by different risks informs prevention by providing an account of health loss different to that provided by a disease-by-disease analysis. No complete revision of global disease burden caused by risk factors has been done since a comparative risk assessment in 2000, and no previous analysis has assessed ch...

Injury prevention plays a key role in keeping children safe, but emerging research suggests that imposing too many restrictions on children's outdoor risky play hinders their development. We explore the relationship between child development, play, and conceptions of risk taking with the aim of informing child injury prevention. Generational trends...

Injuries and violence are among the oldest health problems facing humans. Only within the past 50years, however, has the problem been addressed with scientific rigor using public health methods. The field of injury control began as early as 1913, but wasn't approached systematically or epidemiologically until the 1940s and 1950s. It accelerated rap...

There are now more than 200 million licensed drivers, who drive an average of 13,000 miles per year on 4 million miles of roads. In 2010 crashes resulted in nearly 33,000 deaths and millions of nonfatal injuries. This article describes the Injury Center's response to this public health threat from our beginnings as a small Center in 1992, current m...

A major health threat facing young people today is injury and violence. Injuries may cause temporary pain and inconvenience for some, but for others, injury can lead to disability, chronic pain, and a change in lifestyle. Understanding the public health burden, who is at risk, and the epidemiology of injury is critical to its prevention. In 2007, i...

This journal aims to promote, publish and promulgate high-quality, innovative research. As laudable as this is, it is not enough. Unless this research culminates in practical and cost-effective interventions capable of attracting the political and social support required to allow effective implementation, it will not prevent harm or save lives.1 T...

Although being active is vital to the health and well-being of children, increases in physical activity can lead to an elevated risk of injury, which is a leading cause of childhood mortality globally. This article provides an overview of the evidence base concerning unintentional injuries associated with popular forms of physical activities for yo...

To make an impact on the public's health, evidence-based interventions must be disseminated broadly, supported by training and technical assistance, adopted widely, and implemented as designed. Many effective older adult fall prevention interventions have been identified, but too few have gained wide community acceptance and little is known about t...

Road traffic injuries are the ninth leading cause of death in the world, resulting in 1.3 million deaths and between 20 and 50 million nonfatal injuries each year. These injuries are the leading cause of death among young people aged 15-29 years. The WHO, the World Bank, the UN, FIA Foundation, and other global entities have taken a strong stand ag...

A systematic review of the literature to assess the effectiveness of ignition interlocks for reducing alcohol-impaired driving and alcohol-related crashes was conducted for the Guide to Community Preventive Services (Community Guide). Because one of the primary research issues of interest--the degree to which the installation of interlocks in offen...

The United States (US) Centers for Disease Control and Prevention (CDC), and key partners conducted a systematic review of the effectiveness of 0.08% blood alcohol concentration (BAC) laws on alcohol-related traffic mortality. Review findings of strong evidence of effectiveness were presented by partners during US Congressional hearings contributin...

Injuries are not accidents. Injuries occur for identifiable reasons, many of which are related to factors in the built environment. Injuries are a major cause of death, disability, and suffering, and therefore a leading public health priority. Most injuries are preventable. Injury prevention strategies that modify the environment to reduce risk and...

This article reviews fall prevention research using the Centers for Disease Control public health model and suggests several critical research questions at each step. Research topics include surveillance and data systems, fall risk factors, development, evaluation and implementation of fall interventions, translation of interventions into programs,...

Today we can prevent, treat, or cure most of the deadliest diseases known to humankind—and yet more than a million people around the world die every year— 42,000 in the U.S. alone—from traffic injuries (Sleet, Dinh-Zarr, and Dellinger

p> Background : Injury as a cause of significant morbidity and mortality has remained fairly stable in countries with developed economies. Although injury prevention often is conceptualised as a biomedical construct, such a reductionist perspective overlooks the importance of the psychological, environmental, and sociocultural conditions as contrib...

This case study examines the translation of evidence on the effectiveness of laws to reduce the blood alcohol concentration (BAC) of drivers into policy. It was reconstructed through discussions among individuals involved in the processes as well as a review of documentation and feedback on oral presentations. The Centers for Disease Control and Pr...

In 2009, the Centers for Disease Control (CDC) National Center for Injury Prevention and Control (NCIPC) developed a comprehensive research agenda that described the research needs and priorities for 2009–18.1 The research priorities were identified as those that warrant the greatest attention and intramural and extramural resources from the NCIPC...

Unintentional injuries are the largest source of premature morbidity and mortality and the leading cause of death among adolescents 10-19 years of age. Fatal injury rates of males are twice those of females, and racial disparities in injury are pronounced. Transportation is the largest source of these injuries, principally as drivers and passengers...

Injuries are the leading cause of morbidity and mortality confronting U.S. military forces in peacetime or combat operations. Not only are injuries the biggest health problem of the military services, they are also a complex problem. The leading causes of deaths are different from those that result in hospitalization, which are different from those...

Militaryhealthandreadi-nessdependsonanintensiveefforttocontrolinjuries.Giventhehistoricalsuccessofthemilitaryinwardingoffinfectiousand communicable diseases, the Armed Forces are takingtherightstepnowbyinvestingininjuryprevention.The Centers for Disease Control and Prevention(CDC) itself did not immediately recognize injuries as apredictable and pr...

TITLE: A Process to Identify Military Injury Prevention Priorities Based on Injury Type and Limited Duty Days. BACKGROUND: Injuries, one of the leading public health problems in an otherwise healthy military population, affect operational readiness, increase healthcare costs, and result in disabilities and fatalities. This paper describes a systema...

This article introduces the field of injury prevention and control and its relationship to lifestyle medicine. A review of injury epidemiology, definitions, intervention approaches, and the importance of injury as a public health problem are discussed. Injuries are a large, predictable, and preventable national and international problem affecting i...

On average, 33 children die each day in the United States— about 12 000 children a year— because of unintentional childhood injuries. Another 9 million children are treated in emergency departments for unintentional injuries each year. To address this issue, the Centers for Disease Control and Prevention’s National Center for Injury Prevention and...

A person’s interaction with the environment represents a system for research and focus. Human factors is a discipline dedicated to studying this system. The authors provide a summary of how the field human factors informs and enhances injury control programs. They introduce perception, cognition, and environmental design components that should be c...

Many injuries are preventable, and most have a behavioral component on their causal pathway. However, far more effective use of theory-based approaches to behavioral risk management is needed, which remains a challenge for practitioners. This review discusses theories and applications of behavioral change principles for use in primary care and comm...

Motor vehicle crashes result in more than 40 000 deaths and 4.3 million nonfatal injuries annually. Many known effective strategies to address these preventable deaths and injuries are closely related to lifestyle factors. Clinicians can play a large part in supporting effective interventions in their practice, for example, by counseling patients a...

A systematic review was conducted to determine the effectiveness and economic efficiency of multicomponent programs with community mobilization for reducing alcohol-impaired driving. The review was conducted for the Guide to Community Preventive Services (Community Guide). Six studies of programs qualified for the review. Programs addressed a wide...

To introduce the field of injury control and public health approaches to injury prevention. A review of injury epidemiology, definitions, intervention approaches, and the importance of injury as a public health problem. Injuries are a large national and international problem affecting families and communities. Injuries are predictable and preventab...

Unintentional injuries are the leading cause of morbidity and mortality among children in the United States. This report uses data from the National Vital Statistics System and the National Electronic Injury Surveillance System - All Injury Program to provide an overview of unintentional injuries related to drowning, falls, fires or burns, transpor...

The Centers for Disease Control and Prevention (CDC) in December, 2008, released the 'CDC Childhood Injury Report: Patterns of Unintentional Injuries among 0-19 year olds in the United States, 2000-2006'. The CDC childhood injury report provided significant information to work of practitioners, policy-makers, elected officials, and researchers to u...

This article summarizes what is known about trafffic injury and alcohol-impaired driving, and suggests evidence-based interventions to reduce impaired driving and to reduce traffic injuries that result from alcohol-impaired and drug-impaired driving

Tai chi--moving for better balance, a falls-prevention program developed from a randomized controlled trial for community-based use, was evaluated with the re-aim framework in 6 community centers. The program had a 100% adoption rate and 87% reach into the target older adult population. All centers implemented the intervention with good fidelity, a...

This study was designed to develop an evidence- and community based falls prevention program -- Tai Chi: Moving for Better Balance. A mixed qualitative and quantitative approach was used to develop a package of materials for program implementation and evaluation. The developmental work was conducted in 2 communities in the Pacific Northwest. Partic...

Problem: Falls are a leading cause of mortality and morbidity among adults age 65 and older. Population models predict steep increases in the 65 and older population bands in the next 10-15 years and in turn, public health is bracing for increased fall rates and the strain they place on health care systems and society. To assess progress in fall p...

About 4% of the global burden of disease is attributed to alcohol, which contributes to 3.2% of deaths and 4.0% of the disability-adjusted life years lost. Of the 2 billion alcohol consumers worldwide, over 76 million have been diagnosed with alcohol use disorders (Room et al., 2005). As well as being the leading risk factor for disease burden in l...

Motor-vehicle-related deaths and injuries take a heavy toll on health in the United States, and motor vehicle crashes result in more than 40,000 deaths and more than three million nonfatal injuries each year. They are the leading cause of death among children, youth, and young adults (Centers for Disease Control and Prevention [CDC], 2005). Motor-...

Despite the existence of many effective interventions, including those described throughout this handbook, more than 160,000 injury- and violence-related deaths occurred in the United States in 2002 (Centers for Disease Control and Prevention [CDC], 2005). In addition, in 2003, there were nearly 30 million nonfatal injuries requiring emergency depa...

Behavioral science has made a wide range of contributions to developing and sustaining public health. Behavioral, psychosocial and sociocultural factors associated with lifestyle behaviors are major contributors to morbidity and mortality. Efforts to control behaviors contributing to obesity, heart disease, diabetes, cancer, and HIV have successful...

Alcohol, the most commonly used drug among adults and adolescents (Substance Abuse and Mental Health Services Administration [SAMHSA], 2004), is related to many adverse health outcomes, including injuries and deaths (Room, Babor, & Rehm, 2005). In 2001, excessive alcohol use was associated with approximately 75,000 deaths and 2.3 million years of p...

A systematic review of the literature to assess the effectiveness of school-based programs for reducing drinking and driving and riding with drinking drivers was conducted for The Guide to Community Preventive Services (Community Guide). Thirteen peer reviewed papers or technical reports, which met specified quality criteria and included evaluation...

Behavioral and social sciences theories and models have the potential to enhance efforts to reduce unintentional injuries. The authors reviewed the published literature on behavioral and social science theory applications to unintentional injury problems to enumerate and categorize the ways different theories and models are used in injury preventio...

Motor vehicle-related injury is the leading cause of death in the United States for people aged 1 to 34 years. In 2002, 17,419 (41%) of 42,815 traffic deaths were alcohol related. To estimate trends in alcohol-impaired driving among U.S. adults from 1993 through 2002. The Behavioral Risk Factor Surveillance System, a random-digit telephone survey o...

The conditions that give rise to drinking and driving are complex, with multiple and interrelated causes. Prevention efforts benefit from an approach that relies on the combination of multiple interventions. Health promotion provides a useful framework for conceptualizing and implementing actions to reduce drinking and driving since it involves a c...

A systematic review of the effectiveness of mass media campaigns for reducing alcohol-impaired driving (AID) and alcohol-related crashes was conducted for the Guide to Community Preventive Services (Community Guide). In eight studies that met quality criteria for inclusion in the review, the median decrease in alcohol-related crashes resulting from...

A recent systematic literature review found that primary enforcement laws are more effective at increasing seat belt use than secondary laws in the United States. This report re-examines the studies included in the systematic review to explore whether the benefits of a primary law differ based on: (1) the baseline seat belt use rate; or (2) whether...

Although the likelihood of fire-related death in homes with smoke alarms is about one-half that in homes without alarms, alarm effectiveness is limited by behavior. Only 16% of residents of homes with alarms have developed and practiced plans for escape when the alarm sounds. We reviewed literature to identify behavioral constructs that influence s...

The use of safety belts is the single most effective means of reducing fatal and nonfatal injuries in motor-vehicle crashes. This paper summarizes the systematic reviews of two interventions to increase safety belt use: primary enforcement safety belt laws and enhanced enforcement of safety belt laws. The reviews were previously published in the Am...

Reducing the burden of injury is a national and international goal that requires interdisciplinary approaches. Behavioral and social sciences are an integral part of comprehensive and effective injury-prevention efforts, yet they have lagged behind other approaches. We have only limited knowledge about how to change individual and population injury...

To introduce the readers to the field of injury prevention and comprehensive public health intervention approaches. A review of injury epidemiology, statistics, definitions, intervention approaches, and the importance of health promotion is provided. Behavioral, environmental, and technological solutions will be necessary to reduce or eliminate the...

More than 100 contributors from across the United States, all recognized experts in their fields, present information on the vast racial and ethnic health disparities, as well as approaches that can be used to reduce or eliminate these disparities. Chapters address topics from heart health, hypertension, diabetes, asthma and lung disease, and HIV/A...

A pioneer in injury prevention and traffic safety Patricia Mary Florence Theresa Fossum Waller, 70, died at her home on 15 August 2003, following a nine month battle with metastatic colon cancer. We had the good fortune of knowing and working with Pat to promote highway safety in the context of public health. She was a friend and mentor to many....

Approximately two-thirds of all deaths among children and adolescents aged five to 19 years results from injury-related causes: motor-vehicle crashes, all other unintentional injuries, homicide, and suicide. Schools have a responsibility to prevent injuries from occurring on school property and at school-sponsored events. In addition, schools can t...

The epidemiology of unintentional injury and violence, including likely causes and individuals' abilities to respond to risks, are closely related to the stages of human development. The epidemiology and prevention of injury are also influenced by the social contexts (i.e., family, community, and socio-cultural) in which human development occurs. T...