Injury and Violence Prevention

Injury and Violence Prevention

Photo of a mom and kidUpdated January 2013

Injuries, such as falls, motor vehicle crashes, intimate partner violence and child maltreatment, are a major public health issue. Injuries cause almost 170,000 deaths each year, and are the leading cause of death for people age 1 to 44. Fifty million injuries per year take a physical and an economic toll, with each year's injuries leading to estimated lifetime costs of $406 billion in medical expenses and lost productivity. The World Health Organization estimates that by 2020, traffic-related injuries alone will be the third leading contributor to the global burden of disease and injury. Recognizing the social and economic burden of injury is critical to determine the appropriate level of intervention and investment into specific injury prevention activities. This burden is what makes injury and violence prevention a public health issue.

This Injury and Violence Prevention Overview webpage is intended to be a resource for general inquires into injury prevention. Topics include: childhood injury, child maltreatment, falls among older adults, motor vehicle safety, poisoning, prescription drug overdose and abuse, sexual violence, shaken baby syndrome, teen dating violence, traumatic brain injury and youth violence. Each topic offers a brief overview, selected legislative tracking, NCSL resources and other related resources.

Injury and Violence Prevention Topics:   

Childhood Injury || Child Maltreatment || Falls Among the Elderly || Motor Vehicle Safety || Poisoning || Prescription Drug Overdose and Abuse || Sexual Violence || Shaken Baby Syndrome || Suicide|| Teen Dating Violence || Traumatic Brain Injury || Youth Violence

"Frequently Asked Questions" (PDF file-2 pages)

Important NCSL Resources:

Violence and Injury: Strategies For Prevention 2013 (PDF)

The Burden of Prescription Drug Overdoses on Medicaid (PDF)

Cost of Injury [Postcard]

Injury Prevention [LegisBrief]

Preventable Injuries and State Budgets [Legislative Summit 2010]

Injury and Violence Prevention Topics

Childhood Injury

Injuries are the leading cause of death and disability for children and adolescents.  One in four children are injured severely enough to necessitate medical attention, miss school and/or must be on bed rest each year. For every child who dies from an injury, approximately 34 are hospitalized and 1,000 make emergency room visits. According to the Centers for Disease Control and Prevention (CDC), on average, 12,000 children aged one to nineteen die each year from unintentional injury, which accounts for 44% of all deaths in this age group.

NCSL Resources: 

Keeping Kids Safe Down on the Farm [SL Magazine]
Unintentional Childhood Injuries [LegisBrief]

Other Resources:
Children's Safety Network   
The Children's Safety Network's State Injury Prevention Profiles webpage contains state-by-state public health department injury prevention information including key contacts, state resources and injury topics addressed by the department.
Safe Kids USA   
The Safe Kids USA website contains a public policy database with state and federal laws and regulations encompassing various children's injury prevention issues.

Child Maltreatment

Child maltreatment ranges from neglect to emotional, physical or sexual abuse. According to the CDC, there were approximately 800,000 cases of child maltreatment in 2007, with 1,700 deaths. Rates of maltreatment are highest among infants—those under age 1—and decline through adolescence. In addition to the immediate harms of child maltreatment, over time maltreatment can cause developmental impairment, lead a child to risky behavior and chronic disease and, eventually, earlier death.

NCSL Resources: 

Maternal, Infant and Early Childhood Home Visitation Programs 
2012 Child Welfare Enacted Legislation Database
Prevention Programs and Strategies: State Legislative Experiences
Protecting Students From Offending Teachers [State Legislatures Magazine]
Taking A Different Approach [In Brief]


Other Resources: 
Center for Disease Control and Prevention: Child Maltreatment Prevention 
The CDC’s Child Maltreatment Prevention research and programs work to understand the problem of child maltreatment and prevent it before it begins.
Pew Home Visiting Inventory 
The Pew Home Visiting Inventory provides state leaders, agency administrators and program directors with a state-by-state and national snapshot of home visiting programs, models and funding.
Child Welfare Information Gateway 
This website provides access to information and resources to help protect children and strengthen families.
Triple P: Positive Parenting Programs
Triple P is an example of a multi-level, parenting and family support program which aims to prevent behavioral, emotional and developmental problems in children. 

Falls Among Older Adults

One in three adults age 65 and older falls each year. In 2005, 15,800 people age 65 and older died from injuries related to unintentional falls, about 1.8 million people age 65 and older were treated in emergency departments for nonfatal injuries from falls, and more than 433,000 of these patients were hospitalized.  The CDC has developed tools and resources for practitioners and caregivers about preventing falls.

NCSL Resources: 
Elderly Fall Prevention Legislation and Statutes
Preventing Falls Among Older Americans [LegisBrief]

Other Resources:
CDC Overview of Elderly Falls
This website provides information, resources, and publications related to the prevention of elderly falls, including tools and resources for practitioners and caregivers
Relevant Interventions to Prevent Falling in Older Adults
The information in this article is provided by the U.S. Preventive Services Task Force and is intended to help clinicians, employers, policymakers and others make informed decisions about the provision of health care services.

Motor Vehicle Safety

In the United States, motor vehicle–related injuries are the leading cause of death for people ages 1–34, and nearly 5 million people sustain injuries that require an emergency department visit. The economic impact is also notable: motor vehicle crashes cost around $230 billion in 2000. The CDC has identified motor vehicle related injuries as a major public health problem by targeting groups at high risk of injury or death including child passengers, teen drivers, and older adult drivers. From Graduated licensure programs for teens to ignition interlock devices for convicted drunk drivers, states also have responded to this important public health issue in multiple ways. 

NCSL Resources:

Traffic Safety Legislation Online Tracking Database
Distracted Drivers [Postcard]
State Seat Belt Laws [Postcard]
Motorcycling Can Be Risky [State Legislatures Magazine]

Other Resources:
National Highway Traffic Safety Administration (NHTSA)
NHTSA directs the highway safety and consumer programs established by the National Traffic and Motor Vehicle Safety Act of 1966, the Highway Safety Act of 1966, the 1972 Motor Vehicle Information and Cost Savings Act, and succeeding amendments to these laws.
CDC Motor Vehicle Safety
We focus on improving car and booster seat and seat belt use and reducing impaired driving, and helping groups at risk: child passengers, teen drivers, and older adult drivers. CDC also works to prevent pedestrian and bicycle injuries.

Graduated Driver Licensing

Motor vehicle crashes are the leading cause of death for U.S. teens, accounting for 36 percent of all deaths in this age group. In 2004, 4,767 teens ages 16 to 19 died of injuries caused by motor vehicle crashes. The risk of motor vehicle crashes is higher among those ages 16 to 19 than other age groups. Per mile driven, teen drivers ages 16 to 19 are four times more likely than older drivers to crash. Research suggests that the most strict and comprehensive graduated driver licensing (GDL) systems are associated with reductions of 38 percent in fatal and 40 percent in non-fatal injury crashes involving 16-year-old drivers.   

NCSL Resources:
Nighttime Driving Restrictions for Unsupervised Teen Drivers [Postcard]
Lowering the Minimum Legal Drinking Age - January 2009 [LegisBrief]
Teen Driver Tune-up [State Legislatures Magazine]
Minimum Legal Drinking Age [Public Health Herald]

Other Resources:
Licensing System for Young Drivers: Insurance Institute for Highway Safety
This report from the Insurance Institute for Highway Safety evaluate the licensing systems using criteria designed to estimate the strength and likely effectiveness of the systems in reducing injuries, and reviews the states with graduated licensing laws.
Teens Behind the Wheel: Graduated Driver Licensing (Center for Disease Prevention and Control)
This website provides research and resources which suggests the most strict and comprehensive graduated driver licensing (GDL) systems are associated with a reduction in non-fatal and fatal injuries.


Every 13 seconds in the United States a poison control center receives a call about an unintentional poisoning.  Ninety-three percent of poisonings happen in the home.  More than half of the two million poisoning incidents each year involve children younger than six years of age. The most common exposures in children less than six years old were cosmetics or personal care products. According to the Institute of Medicine, every dollar spent on poison control center services saves $7 in medical spending.

NCSL Resources: 
Poison Control Center Laws
Poisoning as a Leading Cause of Injury Deaths [Postcard]

Other Resources:
CDC Poisoning Homepage - CDC website includes facts, research, and activities surrounding poisoning.
National Safety Council: Safety At Home - Poisoning
Poisonings include the unintentional overdose, misuse of over-the-counter, prescription and illicit drugs, or unintentional exposure to household chemicals and other substances. This website includes information and resources regarding the different types of poisoning.

Prescription Drug Overdose and Abuse

In 2005, more than 22,000 people died from unintentional poisoning.  Many people are surprised to learn that there are over 9,000 unintentional drug overdose deaths by opioid analgesic each year, which is more than twice that of cocaine and over four times that of heroin. Prescription drug abuse is a growing concern among the public and state legislators alike.

NCSL Resources: 

Prevention of Prescription Drug Overdose and Abuse Legislation

Prescription Drug Overdose [NCSL Postcard]

The Burden of Prescription Drug Overdoses on Medicaid (PDF)

A Pill Problem [State Legislature Magazine]

National Groups Work to Curb Abuse [State Legislature Magazine] 

Other Resources:
CDC Issue Brief: Unintentional Drug Poisoning in the United States
CDC’s Injury Center has developed this issue brief  in response to increase in deaths from unintentional drug poisoning in the United States between 1999 to 2006.
National Institute on Drug Abuse (NIDA)
NIDA's mission is to lead the Nation in bringing the power of science to bear on drug abuse and addiction. 
National Alliance for Model State Drug Laws (NAMSDL)
NAMSDL is a resource for governors, state legislators, attorneys general, drug and alcohol professionals, community leaders, the recovering community, and others striving for comprehensive and effective state drug and alcohol laws, policies, and programs.

Sexual Violence

Sexual violence may include rape, stalking or unwanted sexual comments or advances, where consent is not obtained or freely given, regardless of the relationship with the victim. Sexual violence affects an individual’s physical, mental, and emotional health and is recognized as a serious public health problem. Sexual violence occurring between intimate partners is most common, and carries a heavy financial burden; $4.1 billion annually in medical and mental health care costs, and almost $1 billion in lost productivity.

Other Resources: 
CDC Sexual Violence
Sexual violence (SV) is any sexual act that is perpetrated against someone's will and encompasses a range of offenses, including a completed nonconsensual sex act, an attempted nonconsensual sex act, abusive sexual contact, and non-contact sexual abuse. These four types are defined in more detail on this page.
National Sexual Violence Resource Center
The National Sexual Violence Resource Center serves as the nation’s principle information and resource center regarding all aspects of sexual violence.

Shaken Baby Syndrome 

Shaken baby syndrome covers a variety of symptoms associated with the violent shaking of an infant or young child. This shaking usually occurs when a caretaker becomes frustrated such as when the child is crying. Prevention efforts typically include educating new parents on the dangers of shaken baby syndrome and coping mechanisms to resolve parental anger or frustration.

NCSL Resources: 
Shaken Baby Syndrome Prevention Legislation

Other Resources:
CDC Heads Up: Prevent Shaken Baby Syndrome
Shaken Baby Syndrome (SBS), a form of abusive head trauma (AHT) and inflicted traumatic brain injury (ITBI), is a preventable and severe form of physical child abuse. This page offers information and resources to prevent shaken baby syndrome.
National Center on Shaken Baby Syndrome
The National Center's mission is “to educate and train parents and professionals, and to conduct research that will prevent the shaking and abuse of infants in the United States”.


Suicide is among the leading cause of death among teens and adults, accounting for about 4,400 deaths annually.  Among high school students in 2007, 15 percent report having seriously considered suicide in the past year, 11 percent created a suicide plan and 7 percent attempted suicide.

NCSL Resources:
Too Soon To Die [SL Magazine]
Preventing Teen Suicide [LegisBrief]
Alcohol and Suicide [State Health Notes]
Mental Health Screenings For Teens: What Role Do States Play
State Mental Health Lawmaker’s Digest

Other Resources:
CDC Suicide Prevention
General CDC information about suicide prevention.
American Foundation for Suicide Prevention
National organization that provides research, education and outreach to people with mental disorders and those impacted by suicide.
Suicide Prevention Resource Center
Provides prevention support, training, and resources to assist organizations and individuals to develop suicide prevention programs, interventions and policies, and to advance the National Strategy for Suicide Prevention.

Teen Dating Violence

The CDC states that one in 11 adolescents report being a victim of physical dating abuse. The Youth Risk Behavior Surveillance System Survey also found that adolescents who reported being physically hurt in a dating relationship were also more likely to engage in risky sexual behavior, binge drinking, drug use, suicide attempts and physical fighting. Legislators are taking various actions to address teen dating violence. For example, at least five states have passed legislation requiring schools to create curriculums on violence prevention in relationships and training school officials and faculty on how to handle teen dating violence situations. 

NCSL Resources:

Teen Dating Violence Legislation
Percentage of High School Students Who Experienced Dating Violence [Postcard]
Teen Dating Violence Awareness Month [Podcast]

Other Resources:
Choose Respect A CDC initiative aimed at adolescents raises awareness about teen dating violence and promotes healthy relationship practices by challenging harmful beliefs about dating violence.
Teen Dating Violence Awareness Month This site is a collaborative effort to promote February as Teen DV Month by serving as a clearing-house for all related activities.

Traumatic Brain Injury

Traumatic Brain Injury is estimated to have direct and indirect costs of $60 billion to society annually on top of the emotional burden faced by family and friends of someone who suffers a TBI. Effective treatment for TBI suffer can save money. Adherence to treatment guidelines for severely injured TBI patients costs $2,618 per person but will save $11,280 in direct medical costs.

NCSL Resources:

Traumatic Brain Injury Legislation
Sidelined for Safety [State Legislatures Magazine]
Heads Up! Interview with NFL Commissioner Roger Goodell [State Legislatures Magazine]

Other Resources:
Brain Injury Association of America (BIAA)
BIAA is the leading national organization serving and representing individuals, families and professionals who are touched by a life-altering, often devastating, traumatic brain injury (TBI).
CDC Traumatic Brain Injury
CDC’s research and programs work to prevent TBI and help people better recognize, respond, and recover if a TBI occurs.

Youth Violence

Youth violence is a serious public health problem that affects physical, mental and emotional health.

NCSL Resources:
Youth Violence Prevention [Postcard]
How States Are Addressing School Bullying [December 2010 Webinar]
Cyberbullying Enacted Legislation (2006-2010)

Other Resources:
Striving to Reduce Youth Violence Everywhere, STRYVE
A national initiative, led by the Centers for Disease Control and Prevention (CDC), which takes a public health approach to preventing youth violence before it starts.
Harvard Youth Violence Prevention Center
Harvard produces knowledge through research, reproduces knowledge through higher education, and translates knowledge into evidence that can be communicated to the public, policy makers, and practitioners to advance the health of populations.

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*External links are included for informational purposes only and do not imply an endorsement of the content.


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