Childhood injuries: where we are.
 In this paper we present the leading causes of fatal childhood injury in the United States.
 We examine three types of explanations for why injury rates are so high in the United States compared with what they could be and actually are in a number of industrialized European countries.
 Our conclusions are based on what we learn when we look at specific injury problems and apply that knowledge to the field of childhood-injury prevention as a whole.
 To decrease the number of fatal injuries to children, we should: 1.
 Recognize injuries as a major public health problem.
 Injuries have been perceived not as problems to be solved but as "accidents" which are determined by fate, not understandable, and consequently not preventable.
 In addition, injuries have not been addressed in the multidisciplinary fashion that typifies the successful public health approach to other problems.
 2.
 Address intentional injury as part of the problem.
 Intentional injury has been treated as a separate field entirely and not addressed scientifically as a public health problem.
 One consequence of this is that injuries due to firearms have been addressed most frequently as a problem of "unintentional injury." As a result, 93% of all firearm injuries, ie, those which are intentional, have not been studied or addressed adequately.
 This situation is like studying motor vehicle injuries but excluding drunk driving and speeding as contributing factors, or like studying acquired immunodeficiency syndrome but ignoring anal intercourse or intravenous drug use.
 3.
 Develop and support organizations that can plan and coordinate effectively a national approach to injury control.
