Injuries: a continuous challenge for public health

This thesis deals with injuries, a public health problem often neglected by health policy makers and the medical profession. It will focus on trends in the societal burden of this impol1ant "disease". In fact, injuries reflect one of the most persistent public health problems of all times. Almost half a centUlY ago, John Gordon, one of the founding fathers of injury epidemiology, reported that death rates fom injuries had remained virtually unchanged between 1900 and 1946 and had shifted from the sixth to the third most important calise of death in the USA'. More recent analyses from several industrial countries have shown only minor changes in the overall injury mortality rates over the entire past centlllY, especially in comparison to the spectacular decreases in mortality due to infectious diseases.'"' The current injlllY mortality rates of many industrialized countries more or less existed already at the beginning of this centlllY. They are probably velY much the same as those prevailing at the beginning of "modernization" in the nineteenth century, as can be derived from historical data from England and Wales.'-· Moreover, injuries being an even more important cause of death in premodern times seems plausible.

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