Perceptions of injury causes and solutions in a Johannesburg township: implications for prevention

As with other diseases, citizen perceptions of injury causes and solutions are important determinants of their response to the problem. This study explores qualitative responses to questions about the causes and solutions for injuries due to violence, transport, and unintentional burns, falls and other causes from 1,075 residents in six neighbourhoods of a low-income area in Johannesburg, South Africa. These included council houses, council apartment blocks and informal settlements. Data were analysed using content analytic procedures. Perceived causes of injury varied sharply between neighbourhoods. Violence was seen as an outcome of unemployment, socialisation, drug abuse and drug dealing in the formal housing areas, while in the informal settlements it was attributed to unemployment, poor housing and environmental conditions, and excessive alcohol consumption. In the formal housing areas, suggested solutions for violence emphasised increased policing and other repressive measures that contradicted the attribution of causes to environmental factors. In the informal areas, solutions were more congruent with perceived causes, emphasising housing development, education and employment. Perceived causes and solutions for transport injuries reflected the specific context of each neighbourhood, and indicated strong support for the implementation of environmental modifications to reduce the speed of motor vehicles and thus the number of pedestrian injuries. Where perceived causes and solutions for violence and transport-related injuries were located beyond the community in the broader environment, unintentional injuries due to other causes were seen as more in the sphere of potential personal control, except in the informal areas where electrification and formal housing provision were the most commonly suggested solutions. Popular constructions of the causes and solutions for major categories of injury are important in shaping injury prevention responses, and their careful assessment can increase the likelihood that safety promotion programmes will succeed.