Success Stories in Injury and Violence Prevention

While We Were SleepingDavid Hemenway is Professor of Health Policy at the Harvard School of Public Health, Director of the Harvard Injury Control Research Center, and Director of the Harvard Youth Violence Prevention Center. His previous books include Private Guns, Public Health. Hemenway is also the author of While We Were Sleeping: Success Stories in Injury and Violence Prevention, which was published by UC Press in March 2009. In his blog entry below, Hemenway discusses some success stories he mentioned during a visiting lecture.


By: David Hemenway

Everything is about economics?

Last week I gave a lecture about “While We Were Sleeping” at Saint Michael’s, a small liberal arts college in Vermont.   The talk was to a full house of economics faculty and students, a number of whom who were being inducted into the Omicron Delta Epsilon honor society.  There was also a dinner with students, faculty, the president and other college administrators.  Everyone was so welcoming, and I was extremely impressed by the caliber of the students, and how much they liked their college experience.

Because the audience was primarily economics majors, I tried to make my talk relevant to their studies.    What does a talk about advocates and activists who have helped make the world safer—by helping to reduce motor vehicle deaths, burn injuries, violence, suicide, industrial accidents, etc—have to do with what the students were studying?

Fortunately I am an economist, so I made sure that one of the heroes I talked about was a labor economist—John B. Andrews—who successfully promoted taxation rather than prohibition as a way to reduce the use of white phosphorous, which was causing an horrific workplace poisoning known as “phossy jaw.”  One historian has written that Andrews  “orchestrated the most significant legislative success achieved by advocates of workers’ health in the early twentieth century.”

I also talked about some possible lessons for economists.  Some of the successes illustrated the power of the market.  For example, improved ski boots and bindings (something these Vermont students had an interest in) dramatically reduced lower leg injuries between 1960 and 1980.  Sometimes, however, the market cannot be relied on, when, for example there is poor consumer information or large externalities.  The U.S. government had to require that automotive manufacturers install collapsible steering columns in cars in the 1960s, and that tobacco manufacturers produce cigarettes that were fire-safe in the 2000s. Vermont was the second state to pass such a cigarette law.

Often, however, the issue is not more or less government, but smarter government.  For example, when the government buys or builds mass transit, roads or bridges, they can make them more or less safe for workers and for travelers.  The Washington D.C. metro, for example, was specifically –and successfully–designed to deter crime and violence.

Finally, I talked about the “law of unintended consequences.”  While economists often emphasis the bad unintended consequences of attempts to improve on the market, the unintended consequences of many of the successes in “While We Were Sleeping” were beneficial.  For example, the passage of motorcycle helmet laws not only reduces motor cycle injury, but almost invariably reduces motorcycle theft.  I had the students think about and explain why this would be the case.

One of the nicer aspects of writing this book has been the opportunity of making presentations in various locations and to various audiences.  I did not even know Saint Mike’s existed before my talk there, but it seems like a hidden gem.