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different disciplines in conducting this research, and to promote coordination between states and the federal government in order to reduce the national toll of injury. It is also intended to focus specific attention on the problem of injuries to children.
The bill amends Title III of the Public Service Act by adding a new part titled "Part J-Injury Control." The Secretary of HHS is directed to provide grants for research on injuries to individuals in a variety of relevant disciplines (epidemiology, engineering, biomechanics, rehabilitation, etc.) and to promote efforts at injury control at the state and local levels. The Secretary is also directed to report to Congress on the causes of injuries to children and to recommend approaches to reduce the current incidence of childhood injury.
II. BACKGROUND AND NEED
Injury is a major public health problem in the United States. It causes the deaths of more than 140,000 Americans and permanently disables tens of thousands more each year. Injury is the fourth leading cause of death in the U.S. behind heart disease, cancer and stroke. However, more Americans below the age of 45 die from injuries than from any other cause, and more individuals between the ages of 15 and 24 die from injuries than all diseases combined. Among the elderly the fatality rate (the number of deaths due to injury per 100,000 of population) from injury is higher than among younger individuals.
The economic impact of injuries is significant. Indirect and direct costs together are estimated to be between $75 and $100 billion annually. In addition, injuries are responsible for the largest number of Years of Potential Life Lost (YPLL). YPLL is an index used by the Centers for Disease Control to estimate the impact of potentially preventable deaths occurring early in life.
The National Research Council published a report on injury in 1966, entitled, "Accidental Death and Disability: The Neglected Disease of Modern Society." This report documented the seriousness of injuries in America and recommended that research and manpower support be provided in this area. However, injury control has received relatively low support when compared with funding of cancer, heart disease and other major health problems. Though injury is a major health problem today in America, only two cents of every Federal health research dollar is spent on injury control.
In 1983, Congress directed the Secretary of Transportation through the National Academy of Sciences (of the National Research Council) to determine what is known about injury; what research should be done to learn more; and what arrangements the Federal Government could use to increase and improve the knowledge of injury. In response, the National Research Council (NRC) and the Institute of Medicine (also of NRC) established a Committee on Trauma to examine the public health problem of injury. The results of the committee's study was published in 1985 in a report entitled "Injury in America." The Committee on Trauma reported that "injury is the principal public health problem in America
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today," and that the time has come for the United States to address this problem.
To assist in addressing the problem of injury in America, the Committee recommended that an ongoing Federal research program called a Center for Injury Control be established within the Centers for Disease Control. The proposed center would coordinate and assist the implementation of injury control activities (including research, surveillance systems, education and training in the areas of treatment, prevention and rehabilitation).
Congress appropriated $10 million for fiscal year 1986 to the Department of Transportation through the Centers for Disease Control to implement the recommendations made by the National Research Council report on "Injury in America."
S. 2648-Injury Prevention Act of 1986-authorizes continued appropriations for fiscal years 1988, 1989 and 1990 and sets forth guidelines for implementing a Federal program in injury control.
III. HISTORY OF LEGISLATION
The Committee has a long-standing interest in and concern for the problems involved in accident prevention. This program, while never authorized, was created through appropriations in 1986. It has always been the intent of Congress that the appropriate oversight Committees would pass authorizing legislation.
The Committee considered S. 2648 in executive session on August 6, 1986, and agreed to report it favorably to the Senate.
IV. TEXT OF THE BILL
A BILL To improve the public health through the prevention of childhood injuries Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That this Act may be cited as the [Child Injury] "Injury Prevention Act of 1986".
FINDINGS AND PURPOSES
SEC. 2. (a) The Congress finds and declares that:
(1) Injury is one of the principal public health problems in America, and causes over 140,000 deaths per year.
(2) Injury rates are particularly high for [children] children and the elderly.
(3) Injury causes 50 percent of all deaths for children over the age of one year and two-thirds of all deaths for children over the age of 15 [years] years, and is the leading cause of death for individuals under the age of 44 years. Individuals over the age of 65 years have the highest fatality rates for many injuries.
[(4) Injuries resulting from consumer products are a particularly serious problem. In 1985, over 5,000,000 children suffered injuries resulting from consumer products which were serious enough to require visits to hospital emergency rooms.]
[(5)] (4) Injury control has not been given high priority in the United States, and the research being conducted on injury control and the number of personnel involved in injury control activities are not adequate.
(b) The purposes of this Act are
(1) to promote research into the casues, [mechanics,] diagnosis, treatment, prevention, and control of injuries and rehabilitation from injuries;
(2) to promote cooperation between specialists in fields involved in injury research; and
(3) to promote coordination between Federal, State, and local governments and public and private entities in order to achieve a reduction in deaths from injuries.
PUBLIC HEALTH RESEARCH AND ACTIVITIES RELATING TO INJURY
SEC. [2.] 3. Title III of the Public Health Service Act is amended by adding at the end thereof the following new part:
"PART J-INJURY CONTROL
"SEC. 391. (a) The Secretary, through the Director of the Centers for Disease Control, shall—
"(1) conduct, and give assistance to public and nonprofit private entities, scientific institutions, and individuals engaged in the conduct of, research relating to the causes, mechanisms, prevention, diagnosis, teatment of infuries, and rehabilitation from injuries; and
“(2) make grants to public and nonprofit private entities (including academic institutions, hospitals, and laboratories) and individuals for the conduct of such research.
"(b) The Secretary, through the Director of the Centers for Disease Control, shall collect and disseminate, through publications and other appropriate means, information concerning the practical applications of research conducted or assisted under subsection (a).
"SEC. 392. (a) The Secretary, through the Director of the Centers for Disease Control, shall
"(1) assist States and political subdivisions of States in activities for the prevention of injuries; and
"(2) encourage regional activities between States designed to reduce injury rates.
"(b) The Secretary, through the Director of the Centers for Disease Control, may—
"(1) enter into agreements between the Service and public and private community health agencies which provide for cooperative planning of activities to deal with problems relating to injuries and injury control; and
"(2) work in cooperation with Federal, State, and local agencies to promote injury control.
"SEC. 393. By January 1, [1988,] 1989, the Secretary, through the Director of the Centers for Disease Control, shall prepare and