Injury surveillance.

Public health surveillance is the ongoing, systematic collection, analysis, interpretation, and dissemination of data on health-related events for use in public health action to reduce morbidity and mortality and to improve health (1). More simply put, surveillance is about translating information into action. In the United States, much of the focus of public health surveillance has traditionally been on prevention and control of infectious diseases, an area where surveillance has been used to identify outbreaks, monitor emerging problems, and assess the impact of prevention measures (2– 5). Another essential role of public health surveillance is monitoring causes of death, including premature mortality. In that context, injuries clearly emerge as a major public health problem. In 1999, unintentional injuries were the fifth leading cause of death in the United States and were the leading cause for persons in the age group 1–34 years (6). Unintentional injury, together with homicide and suicide, accounted for nearly 60 percent of all deaths among persons aged 1–34 years (6). Following Congressional authorization in 1983, the National Research Council and the Institute of Medicine (National Academy of Sciences) produced the 1985 report Injury in America (7), which documented the burden of injury and became a major impetus for developing support for research and programs to address this important problem. A 1988 review of public health surveillance in the United States (8) noted that recognition of intentional and unintentional injuries as major public health problems had led to the need for developing systems of public health surveillance for injuries. Additionally, as injury research and prevention programs have evolved, so has the need for surveillance data to identify populations at risk, determine programmatic priorities, support prevention activities, and evaluate prevention efforts. While there have been substantial advances in injury surveillance in recent years, there are still many challenges and needs. In this paper, focusing primarily on the United States, we provide an overview of current injury surveillance data sources and systems, and we review their use for surveillance of major categories of injury. We also present several new developments in injury surveillance and comment on some of the new challenges facing injury surveillance in an era of rapidly changing information technology and growing recognition of the need for effective integration of information systems.