title: Preventing unintentional injuries in the home using the Health Impact Pyramid.
abstract: 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, and poisoning-related injuries, this article illustrates the utility of an approach that incorporates a social-environmental perspective in identifying and selecting interventions to improve the health and safety of individuals. Injury prevention efforts to prevent home injuries benefit from multilevel modifications of behavior, public policy, laws and enforcement, the environment, consumer products and engineering standards, as demonstrated with Frieden's Health Impact Pyramid. A greater understanding, however, is needed to explain the associations between tiers. While interventions that include modiﬁcations of the social environment are being ﬁeld-tested, much more work needs to be done in measuring social-environmental change and in evaluating these programs to disentangle what works best.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA, USA kmack@cdc.gov.
authors.forename: Karin A
authors.initials: KA
authors.lastname: Mack
authors.affiliation: University of South Florida, Tampa, FL, USA.
authors.forename: Karen D
authors.initials: KD
authors.lastname: Liller
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Grant
authors.initials: G
authors.lastname: Baldwin
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Sleet
mesh_terms: D000061:Accidents, Home / Q000517:prevention & control*; D000367:Age Factors; D002028:Building Codes; D002056:Burns / Q000517:prevention & control; D005390:Fires / Q000517:prevention & control; D006266:Health Education / Q000458:organization & administration*; D006801:Humans; D011041:Poisoning / Q000517:prevention & control; D012307:Risk Factors; D012449:Safety; D012737:Sex Factors; D012922:Social Change; D012931:Social Environment; D012959:Socioeconomic Factors; D014947:Wounds and Injuries / Q000517:prevention & control*
keywords: Health Impact Pyramid; falls; fire; injury prevention; poisonings
references.citation: J Burn Care Res. 2006 May-Jun;27(3):314-22; discussion 323-4
references.pmid: 16679899
references.citation: MMWR Morb Mortal Wkly Rep. 2013 Jul 5;62(26):537-42
references.pmid: 23820967
references.citation: Age Ageing. 2006 Sep;35 Suppl 2:ii55-ii59
references.pmid: 16926207
references.citation: Cochrane Database Syst Rev. 2012 Sep 12;(9):CD007146
references.pmid: 22972103
references.citation: J Inj Violence Res. 2013 Jan;5(1):61-9
references.pmid: 22868399
references.citation: Arch Pediatr Adolesc Med. 2011 Apr;165(4):339-45
references.pmid: 21464382
references.citation: Clin Toxicol (Phila). 2013 Dec;51(10):949-1229
references.pmid: 24359283
references.citation: Inj Prev. 1999 Sep;5(3):217-25
references.pmid: 10518271
references.citation: J Urban Health. 2011 Jun;88(3):582-97
references.pmid: 21365355
references.citation: Pediatrics. 2008 May;121(5):930-7
references.pmid: 18450896
references.citation: Am J Health Behav. 2006 May-Jun;30(3):259-67
references.pmid: 16712440
references.citation: Pediatrics. 1979 May;63(5):687-93
references.pmid: 440889
references.citation: Am J Public Health. 1977 Dec;67(12):1143-7
references.pmid: 596496
references.citation: N Engl J Med. 2001 Jun 21;344(25):1911-6
references.pmid: 11419429
references.citation: Pediatrics. 2009 Aug;124(2):541-7
references.pmid: 19596735
references.citation: Am J Public Health. 2010 Apr;100(4):590-5
references.pmid: 20167880
references.citation: Am J Prev Med. 2005 Jan;28(1):80-7
references.pmid: 15626561
references.citation: Int J Inj Contr Saf Promot. 2007 Jun;14(2):109-17
references.pmid: 17510847
references.citation: Accid Anal Prev. 2008 Jan;40(1):61-8
references.pmid: 18215533
references.citation: Am J Prev Med. 2005 Jan;28(1):73-9
references.pmid: 15626560
references.citation: Health Educ Q. 1988 Winter;15(4):351-77
references.pmid: 3068205
references.citation: Health Educ Behav. 2013 Oct;40(5):520-5
references.pmid: 24048612
references.citation: Am J Prev Med. 2009 Sep;37(3):181-7
references.pmid: 19666156
references.citation: Inj Prev. 2007 Apr;13(2):137-40
references.pmid: 17446257
references.citation: J Pediatr Surg. 1983 Aug;18(4):509-11
references.pmid: 6620098
references.citation: Public Health Rep. 2007 Mar-Apr;122(2):224-31
references.pmid: 17357365
references.citation: Inj Prev. 1999 Jun;5(2):145-50
references.pmid: 10385837
references.citation: Arch Pediatr Adolesc Med. 2005 Jun;159(6):557-60
references.pmid: 15939855
references.citation: Am J Prev Med. 2005 Jan;28(1):88-94
references.pmid: 15626562
references.citation: Am J Prev Med. 2013 Mar;44(3):239-46
references.pmid: 23415120
references.citation: Pediatrics. 1991 Sep;88(3):572-7
references.pmid: 1881739
references.citation: Pediatrics. 1982 Mar;69(3):363-70
references.pmid: 7063294
references.citation: JAMA. 1996 Jun 5;275(21):1661-5
references.pmid: 8637140
references.citation: Am J Public Health. 2010 Oct;100(10):1824-5
references.pmid: 20724668
references.citation: Am J Prev Med. 2008 Oct;35(4):370-379
references.pmid: 18779031
references.citation: Public Health Rep. 2012 Mar-Apr;127(2):147-55
references.pmid: 22379214
references.citation: Age Ageing. 1997 May;26(3):195-202
references.pmid: 9223715
references.citation: Cochrane Database Syst Rev. 2011 Feb 16;(2):CD003600
references.pmid: 21328262
references.citation: Pediatrics. 2012 Dec;130(6):1053-9
references.pmid: 23147973
references.citation: Inj Prev. 2009 Jun;15(3):197-204
references.pmid: 19494100