Map of life expectancy at birth from Global Education Project.

Monday, March 30, 2009

Filial Piety

Sorry for the absence, still dealing with family responsibilities. Anyhow . . .

Few of us ever think about the huge reduction in traumatic injuries that Americans enjoyed during the 20th Century. I'm reading a book about this subject, of which more anon once I am ready to write the authoritative Cervantes review, but for now I'll just note that changes in building codes, consumer product regulations, highway design and features, automobile design requirements, workplace safety regulations etc. had an enormous impact of which the public is little cognizant.

The picture is complicated because there are separate statistical systems for workplace injuries, motor vehicle injuries, violent, injuries, etc., but just as one example the death rate from motor vehicle crashes in the U.S. was about 22/100,000 per year in 1980 and has fallen to about 15. Unfortunately, while deaths from other causes of injury have fallen steadily, deaths from accidental poisoning -- meaning mostly drug overdoses -- have been rising lately. Note that the progress results from a combination of technological advances, and government regulation to force builders and manufacturers to use the technology. This is just one more area in which simple-minded libertarian ideology fails utterly.

When I was a child, my cousins had a friend whose nightgown caught fire from brief exposure to a gas burner and who suffered agonizing and disfiguring burns over much of her body. Nowadays, that can't happen, because children's sleepwear is, by law, flame retardant. Think about that, Cato institute.

Unfortunately, one problem for which there is no simple technological or regulatory fix is falls by elderly people. This information service of a consortium of Ohio universities is one of those reliable Web resources I commend to your attention. They tell us that nearly 1/3 of women over 65 will fall every year, and the rate goes up with age. The risk for men is somewhat less but still substantial. Although hip fractures are the classic disastrous consequence of falls, head injuries and back injuries can also occur. These incidents can set people on the path to long-term decline and disability. The National Institute on Aging also gives out a lot of helpful information.

Thoughtfulness about people's physical environment is helpful -- night lights, keeping cords off the floor, making sure there aren't any loose throw rugs, grab bars and railings in all the right places, that sort of thing, can help. It's also important for people to do their best to stay active and to keep up their muscle tone and balance; to be alert to possible drug side effects that might cause dizziness of fainting, and not take any bullshit from their doctors about it; to look after bone strength and all that good stuff. Help out your friends and relatives and neighbors if they need to change ceiling light bulbs or do other chores that require climbing ladders or standing on chairs -- not a good idea if you're getting on, I'm afraid.

Be mindful.


kathy a. said...

interested to see your review, once complete. i would argue that the ability to sue the bastards led to many of the changes in codes, regularions, designs, requirements. there has been an aggressive effort by corporations toward "tort reform" in the past couple of decades; it is sold as "reining in the trial lawyers." not every lawsuit is valid, and not every lawyer is an angel; but there are already ways to sort the totally frivolous lawsuits out before trial. caps on damages and such are pure and simple a way to let corporations get away with knowingly selling unsafe products, or allowing their workers to work in unsafe conditions, etc.

you are right about how bad falls can be for elderly and/or compromised folks, of course. my grandmother broke a second hip tripping over a step in her living/dining room; and due to her poor condition, the hip repair broke through. my mother had osteoporosis; her first break was falling off a folding chair. she shattered her knee many years later, broke a hip, and broke another hip in a gentle fall after a stroke. it's too complicated to get into here, but the combo of hip and a stroke was devastating.

Cervantes said...

True, lawsuits have been part of the story. But I think regulation is even more important.

kathy a. said...

maybe i'm wrong, but i think at least part of the time, regulation follows lawsuits.

roger said...

isn't there a downside to some of the fire retardant chemicals? cancer or something?

Anonymous said...

Great point about how the deaths from such trauma are spread among so many categories tallied separately, so people rarely think of the gains in reducing them all.

Two comments, re: falls, and re: fire retardants --

Since someone close to me suffered a serious head injury in a bathroom fall (by the way, that was rx error-related), I've been interested to learn what people in other countries are doing on that front.

All the points that Cervantes mentions (such as clearing up cords/rugs, adding handholds, improving balance/ muscle strength, addressing rx adverse effects, etc) are the focus of the attention I see in US materials --
rightly aimed at fall prevention.

But in some info from the UK, and maybe elsewhere, I think I've seen more signs of attention to reducing the harm from falls, if they occur -- notably, using resilient flooring instead of tile in bathrooms, for example.

Does anyone here know if such efforts are substantial in other nations?

Also, here's an item on some recent research on neurotoxic fire retardant chemicals --