PEDIATRICS Vol. 90 No. 5 November 1992, pp. 798-807
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Health Consequences of Behaviors: Injury as a Model

Charles E. Irwin Jr. MD1, Michael F. Cataldo PhD2, Adam P. Matheny Jr. PhD3, and Lizette Peterson PhD4

1 From the Division of Adolescent Medicine, Department of Pediatrics, School of Medicine, University of California, San Francisco
2 From the Department of Behavioral Psychology, The Kennedy Kreiger Institute, Department of Psychiatry, The Johns Hopkins University School of Medicine, Baltimore, MD
3 From the Child Development Unit, Health Sciences Center, University of Louisville, Louisville, KY
4 From the Division of Clinical Psychology, Psychology Department, University of Missouri-Columbia

I always like to make things as simple as possible, but no simpler.

—Einstein

As a model for behavioral pediatric research, injury prevention presents a relatively clear example of how behavior can dramatically and directly impact health status. Approaches to injury prevention range from passive, environmental control to the modification of behavior so thát the consequence is safety not injury. Regardless of the level of intervention, behavioral changes of some form are essential for interventions to reduce injuries. Approaches addressing injury prevention exemplify both challenges and models for the interface of behavior and biology wherein the focus is behavior that produces serious biological outcome.

This article will specifically focus on a developmental-psychosoical approach to children's injuries because it incorporates more than one scientific discipline and knowledge base. Increasingly, behavioral pediatric endeavors involve combining research findings and intervention technologies from a number of disciplines. After briefly reviewing the magnitude of the childhood injury problem, we will use four ongoing research programs to exemplify differing levels of analysis within a developmental-psychosocial approach. Further, these programs and this multidisciplinary approach can have generality to other areas of pediatrics that concern a health-behavior interaction.

THE PROBLEM

Injuries are the most common cause of death and hospitalization in the pediatric population.1 Injuries rank as the third leading cause of death (39.0/100 000) for the total US population. The distribution is U-shaped, with the rates of deaths due to injuries ranging from 25.2/100 000 in the younger than 1-year-old age category to a low of 11.7/100 000 in the 5- through 9-year-old age category, and then rising to a high of 51.4/100 000 in the 20- through 24-year-old age category.

Submitted on July 22, 1991
Accepted on May 15, 1992




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