7.6. Future perspectives
Generally in the EU Member States, there is a current
decreasing trend of the rates of injuries, whereby this development is more
pronounced in road traffic and work place and less favourable at home and
during leisure time activities. The growing proportion of old and very old
people and their high risk of falls play a major role in this development. Thus
the public health contribution to injury prevention will become more and more
important compared to those of other political sectors. While general strategic
framework for this approach is available, its implementation is still at an
initial stage. Injury is a major health problem, which can be efficiently
tackled but it does not have the appropriate rank on the health policy agendA.
The situation may change but some restrictions must be considered:
The realization of the proposed leading role of THE
Ministries of health in the field of injury is ambitious. In fact, in many
Member States Ministries of health lack constitutional power as well as actual
capacities for a strong leading function and interdepartmental coordination.
Nevertheless, given the increasing burden of health expenditures and costs of
disabilities, governments will soon realize the great potential of prevention.
As long as nobody can be blamed for creating hazards and
causing injuries (as it is the case in interpersonal violence, road transport
and working conditions), there is a tendency to attribute the main
responsibility to victims and their families. As a consequence, there is no
strong political demand for governmental prevention in the sphere of home and
leisure activities or of suicide and self-harm. The potential for prevention
through policy action is seriously underestimated.
Inequalities also in injury risk and access to safety
remain a major challenge, while gaps between social classes do not tend to
narrow and the social coherence might deteriorate. This will not make it easier
to put the safety needs of vulnerable, but politically less well organised
groups such as the aged, depressed, or socio-economically disadvantaged people
higher on the political agenda.
The decline in the number of fatalities due to injuries is
to a large extent the result of improvements of medical treatment ( e.g. trauma
and emergency care). This success is owed to the fact that there are a few and
strongly organized professional groups involved. The challenge for injury
prevention is to create policy platforms that are as successful as emergency
The most important challenges are identified and tools are
available – at least to a certain extent – for: establishing injury
surveillance and information; formulating national action plans; exchanging
experiences; including injury prevention knowledge in vocational trainings;
improving child safety, safety of elderly, product and service safety.
Additional measures are currently being developed for the safety of
adolescents, prevention of falls, safety of vulnerable road users, and sport
safety. Ther is still much room for improvement in the public health response
to interpersonal violence and self-harm. Also the question of indicators for
health costs and disability has not yet been solved in a satisfying manner. A
remaining challenge is the building up of adequate organizational capacities at
national level, e.g. national focal agencies and research centres. The number
of centres of excellence for injury prevention in Europe is inappropriately
low, when taking into consideration that injury represents the fourth leading
cause of death.