Injury as metaphor: towards an integration of perspectives

Despite some notable successes, the prevailing injury rates connected with transportation, recreation and the workplace suggest that most of the findings from injury research have yet to be taken seriously by the American public or their political representatives. While a number of explanations might be offered for this situation, this paper carefully examines one which ties the social neglect of research knowledge to the diversity of premises and perspectives on injury. The lack of public action to prevent injury in many areas stems not so much from ignorance as from disagreement, and consequently, confusion over the nature of the injury problem and what should be done about it. Most of these disagreements can be traced to the contending perspectives on injury found in research. This paper examines three perspectives, those of economics, law and public health, and analyzes the metaphor each uses to characterize injury for clues about the sources of disagreement among them. Attention then turns to the rationale for integrating these perspective in ways that might accommodate the disagreements and serve as a basis for building a social consensus for public action.