Putting science into action to prevent injuries and violence: Q&A with CDC’s Debra Houry
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* Michele Late

Injuries and violence are major public health issues in the United States, leading to 214,000 deaths annually. Millions of people are also injured each year and survive, sometimes with long-lasting effects. The Nation’s Health spoke with Debra Houry, MD, MPH, director of CDC’s National Center for Injury Prevention and Control, about the ways the center is working to protect Americans from injuries and violence and how health workers can play a role.

## Tell us about the work of the center. What is your mission and main focus?

The mission of CDC’s National Center for Injury Prevention and Control is to prevent violence and injuries through science and action.

For 25 years, CDC’s Injury Center has helped protect Americans from injuries and violence. We are the nation’s leading authority on injury and violence. We study violence and injuries and investigate the best ways to prevent them, applying science and creating real-world solutions to keep people safe, healthy and productive.

We are committed to saving lives, protecting people and lowering the health and societal costs of violence and injuries. Our goal is to offer individuals, communities and states timely, accurate information and useful tools and resources to keep people safe where they live, work, play and learn.

## Why do Americans need to be concerned about injury and violence prevention?

Injuries are a leading cause of death in this country. In the first half of life, more Americans die from injuries and violence — such as motor vehicle crashes, falls or homicides — than from any other cause, including HIV, cancer or the flu. Injuries and violence affect everyone, regardless of age, race or economic status. And, in America, deaths from suicide, opioid overdose and car crashes have been going up in recent years. In 2015 alone, injuries and violence led to 214,000 deaths, 2.8 million people hospitalized and 27.6 million emergency room visits

The economic costs are also staggeringly high. The total lifetime medical and work loss costs of injuries and violence in the U.S. was $671 billion in 2013.

## What are the big issues right now in U.S. injury and violence prevention?

CDC focuses on key injury and violence issues that harm the most people in the U.S. — issues where we also have science about what works to help protect Americans.

*   ***Opioid overdoses:*** Opioids — including prescription opioids and heroin — killed more than 33,000 people in 2015, more than any year on record. CDC works with states, communities and prescribers to prevent opioid misuse and overdose by tracking and monitoring the epidemic, helping states scale up effective programs and supplying health care providers with data, tools and guidance for evidence-based decisionmaking.

*   ***Suicide:*** Each year there are more than 40,000 suicides in the U.S. — an average of about 117 every day. CDC works to prevent suicide by promoting programs and conducting science to reduce factors that increase risk and increasing factors that promote resilience or coping.

*   ***Motor vehicle injury:*** More than 32,000 people are killed and 2 million are injured each year from motor vehicle crashes. CDC uses science to better understand this problem and develop programs that will change behavior to keep drivers, passengers, bicyclists and pedestrians safe on the road every day.

*   ***Traumatic brain injuries:*** Traumatic brain injury is a major cause of death and disability in the United States. Such injuries contribute to about 30 percent of all injury deaths. CDC’s research and programs work to prevent traumatic brain injuries and help people recognize, respond and recover if a traumatic brain injury occurs.

*   ***Violence against children:*** There were 683,000 victims of child abuse and neglect reported to child protective services in 2015. CDC works to ensure children and families have safe, stable nurturing relationships and environments.

![Figure1](http://www.thenationshealth.org/https://www.thenationshealth.org/content/nathealth/47/5/S5/F1.medium.gif)

[Figure1](http://www.thenationshealth.org/content/47/5/S5/F1)

Houry

## What are some programs or strategies that have been working to prevent injuries and violence?

Injuries and violence are so common that we often accept them as just part of life. But they can be prevented and their consequences reduced. The Injury Center does this by putting science into action. For example:

*   We invested more than $50 million in 44 states and Washington, D.C., to support opioid overdose prevention. With that money, and involvement from our scientists, states have strengthened their Prescription Drug Monitoring Programs, improved their electronic health record systems, and shared overdose data with health care providers and law enforcement.

*   Creating business improvement districts — public-private partnerships that invest resources into local services like street cleaning and public safety — in Los Angeles led to a 12 percent reduction in robberies and an 8 percent reduction in overall violent crime in BID neighborhoods.

*   Our Heads Up initiative helps protect kids on and off the sports field by raising awareness of concussion and other serious brain injuries. After using one of the campaign’s toolkits, 77 percent of youth sports coaches reported they could more easily identify athletes who may have a concussion, and 72 percent reported educating other coaches, parents, and athletes.

*   Ignition interlocks can reduce DWI re-offense by 70 percent, but only 1 out of 5 of those arrested for DWI had interlocks installed. We partnered with the National Highway Traffic Safety Administration and the Governors Highway Safety Association to evaluate 28 states and determine eight key features of successful interlock programs.

*   We also support states in tackling other critical injury and violence problems, including providing funds and assistance to all 50 states to prevent sexual violence through our Rape Prevention and Education Program and to 23 states to address their most pressing issues through the Core State Violence and Injury Prevention Program.

![Figure2](http://www.thenationshealth.org/https://www.thenationshealth.org/content/nathealth/47/5/S5/F2.medium.gif)

[Figure2](http://www.thenationshealth.org/content/47/5/S5/F2)

CDC’s Heads Up initiative helps protect kids by raising awareness of concussion and other serious brain injuries.

Photo by Amysuem, courtesy iStockphoto

## What role can public health workers play in preventing injury and violence?

Despite progress in our field, injury and violence is still a leading cause of death in the United States. Rates of suicide are continuing to rise and we remain in the midst of an opioid overdose epidemic that includes deaths from prescription opioids and heroin. We need to continue advancing public health solutions to these problems because we know they work.

Like diseases, injuries are preventable — they do not occur at random. CDC’s Injury Center uses the same scientific methods to prevent injuries that have been used to prevent disease: carefully describing the problem through surveillance, studying factors that increase or decrease risk for injury, designing and evaluating intervention strategies that target these factors, and taking steps to ensure that proven strategies are implemented in communities nationwide.

The Injury Center has developed technical packages to help states and communities take advantage of these proven strategies to prevent violence.

## What one thing would you tell Americans to help them prevent injuries?

Quoting Benjamin Franklin: “An ounce of prevention is worth a pound of cure.” We know that most injury and violence is predictable and preventable. That should be empowering to people.

There’s a lot we know about what works to prevent injuries and violence, and we learn more every day. We want to help keep Americans safe, healthy and productive — and there’s a lot that individuals can do on their own, too.

*For more information on CDC’s National Center for Injury Prevention and Control, visit [www.cdc.gov/injury](http://www.cdc.gov/injury).*

*   Copyright The Nation’s Health, American Public Health Association