Mack Karin A, Liller Karen D, Baldwin Grant, Sleet David
Centers for Disease Control and Prevention, Atlanta, GA, USA
University of South Florida, Tampa, FL, USA.
Health Educ Behav. 2015 Apr;42(1 Suppl):115S-122S. doi: 10.1177/1090198114568306.
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.
在生命的前四十年中，伤害仍然是主要的死亡原因。这些伤害是由行为、身体、结构、环境和社会因素共同作用导致的。综合来看，这些因素说明了采取广泛且多层次的伤害预防方法的重要性。本文以跌倒、火灾、烫伤和中毒相关伤害为例，阐述了一种将社会环境视角纳入其中的方法在识别和选择干预措施以改善个人健康与安全方面的实用性。正如弗里登的健康影响金字塔所示，预防家庭伤害的伤害预防工作受益于行为、公共政策、法律与执法、环境、消费品和工程标准等多层面的改进。然而，需要更深入地理解各层面之间的关联。虽然包括社会环境改进在内的干预措施正在进行实地测试，但在衡量社会环境变化以及评估这些项目以弄清楚哪种措施效果最佳方面，仍有大量工作要做。
