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THE SAFE COMMUNITY CONCEPT – A SUCCESSFUL TOOL FOR INJURY

PREVENTION AND SAFETY PROMOTION

Article · January 2019

DOI: 10.5200/sm-hs.2018.088

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SVEIKATOS MOKSLAI / HEALTH SCIENCES
IN EASTERN EUROPE
ISSN 1392-6373 print / 2335-867X online
2018, 28 tomas, Nr. 7, p. 41-46
DOI: https://doi.org/10.5200/sm-hs.2018.088 VISUOMENĖS SVEIKATA / PUBLIC HEALTH 41

THE SAFE COMMUNITY CONCEPT – A SUCCESSFUL TOOL FOR

INJURY PREVENTION AND SAFETY PROMOTION
Birutė Strukčinskienė1, Sabine Distl2,3, Sigitas Griškonis1,4
1
Faculty of Health Sciences, Klaipeda University, Klaipeda, Lihuania, 2European Safe
Community Network (ESCON), 3Safe Kids Austria/Grosse Schuetzen Kleine, Austria,
4
Klaipeda University Hospital, Klaipeda, Lithuania

Key words: Safe Community, injury prevention, safety effective countermeasures should be implemented for achie-
promotion. ving population -level change [1, 4-6].
International Safe Community model is a successful tool
Summary for the injury prevention and safety promotion [7-10]. Inter-
Injuries remain to be one of the leading causes of de- national Safe Community Programme nowadays is one of
ath and disability in any region of the world. Interna- the most important, cost effective interventional program-
tional Safe Community Programme is most important mes in the field of injury prevention and safety promotion
programme for injury prevention and safety promo- [7-12]. This approach embodies a multi-disciplinary and
tion in community. The aim of study was to introduce multi-sectorial engagement in injury control and promotes
the concept of Safe Community as a successful tool interventions across the full primary, secondary and tertiary
for injury prevention and safety promotion. For this prevention continuum [10]. At Safe Community concept,
study, the scientific literature overview, document safety activities are focused to the community, having in
analysis, and descriptive analysis were used. mind that:
The Safe Community model is a long-term, sustaina-  Every 6 seconds someone, somewhere in the world
ble, and coordinated program, based on partnership is suddenly and tragically killed due to injury;
and collaboration, covering all genders, ages, envi-  Injury takes 5.8 million lives every year, causing
ronments, and situations. Safe Community concept about 9% of global deaths;
targets vulnerable groups and high-risk environments.  Every death creates a hole in the lives of family,
Programme documents the frequency and causes of friends and communities left behind;
injuries, and has evaluation mechanisms. Commu-  Many of these are young lives;
nity itself play the leading role in Safe Community.  Injury is the leading cause of death for people under
Reduced injury rate/morbidity, disability, and mor- 40 years of age;
tality from injuries, and improved quality of life, are  For every death from injury there are dozens of
the results of comprehensive sustainable preventive hospitalisations, hundreds of Emergency Department pre-
work at the community level. The subcategory Safe sentations and thousands of medical appointments;
Schools are promising preventive programmes in-  Some people suffer long term or permanent physical
tended to enhance child safety. or psychological disability because of their injuries [13].
The safety promotion activities at the community level
Introduction have valuable impact to the outcomes of health and safety
Injuries remain to be one of the leading causes of death promotion work. Preventive programs, such as a Safe Com-
and disability for all sectors of the community in any region munity program aloud to reduce injury risk exposure, to
of the world [1, 2, 3]. Researches all over the world discuss, save lives, and to minimize economical and social burden
study and investigate, what works, when and for whom for to community and to society.
the improvement of injury-related health of the communities, The aim of study was to introduce the concept of Safe
what activities and community-based approach could be Community as a successful tool for injury prevention and
a benefit for the elucidation of injury causation, and what safety promotion.

Žurnalo tinklalapis: http://sm-hs.eu Correspondence to: Birutė Strukčinskienė, e-mail: [email protected]

42
Materials and Methods 4. Programs that are based on the available evidence;
The scientific literature overview, document analysis, 5. Programs that document the frequency and causes
and descriptive analysis were used for the study. In addition, of injuries;
the materials from the international conferences, reports, 6. Evaluation measures to assess their programs, pro-
documentary sources, and sources available at the internet cesses and the effects of change;
were used. 7. On going participation in national and international
Safe Communities networks.
Results There are numerous Safe Community Support Centres
Safe Community concept. The International Safe Com- to provide support in the development of the Safe Commu-
munity concept was originally launched at the First World nities programs, and in providing advice and assistance for
Conference on Accident and Injury Prevention held in Stoc- communities in their country and internationally. During
kholm in 1989. In the Manifesto for Safe Communities, is the last decades there were created regional organizations
stated that the International Safe Community movement for support, help and cooperation among communities. The
should work with “WHO Health for all” as a vision. The European Safe Community Network (ESCON) is a members-
program has started in World Health Organization Collabo- hip network created in response to the international need to
rating Centre on Community Safety Promotion at Karolinska share information and resources focused on injury prevention
University (Stockholm, Sweden). From 2015, the program and safe community concept. This Network includes resear-
coordination was and is continued by the International Safe chers, practitioners, safety promotion officers and community
Community Certifying Centre. WHO was heavily enga- groups, other agencies and institutions working with safe
ged in the formation of the International Safe Community community model. The ESCON network is a connection to
movement and was a signatory to the Manifesto for Safe current information on injury prevention, safety promotion
Communities in Stockholm, in 1989. WHO recognizes Safe and practical ways to achieve and improve safe communi-
Communities as an important mechanism for the coordina- ties. There are also other Safe Community networks: Asian
ted implementation of evidence-based action for the pre- Network for Safe Communities, Latin-American Network
vention of violence and injuries by subnational authorities, for Safe Communities, and Eastern Europe Safe Community
local government and communities [7, 9, 12]. According to Network. Safe Community movement is drawing more and
investigations and research, the injuries decrease by more more attention globally among people working in the area
than 25-30 % in Safe Communities. In Safe Community, the of injury prevention and safety promotion. The network is
community itself plays the leading role. Creative methods expanding rapidly and today we count around 400 designa-
of education, physical planning and environmental change ted Safe Communities worldwide, and even more are under
joined with appropriate regulations and enforcement are way to it.
an important beginning for the safety of a community. An In Safe Communities, the focus on local community
International Safe Community uses the traditional means involvement in preventive activities is of importance. The
of control such as economic, regulations and governing by community people the best understand the problems, needs,
objectives and visions. All International Safe Communities lifestyle, resources, capacities of the community, and decide,
serve as models for other communities [7, 8, 10, 12]. Re- how to deal with these problems [8, 14, 15]. Community
duced injury rate/morbidity, disability, and mortality from should decide what environments, ages and fields are most
injuries and violence, and improved quality of life, are the important to work on in regards to the safety in the com-
results of comprehensive sustainable preventive work at the munity. So-called slogan “listen to the community” shows
community level. that the activities in the community should be organized
The seven indicators a community must fulfil to became according to the community needs. According to Seedat et
an International Safe Community are [12]: al (2012), the promotion of safety, peace and health is parti-
1. An infrastructure based on partnership and collabora- ally contingent on democratic citizenship expressed through
tions, governed by a cross- sector group that is responsible active community engagement in the design, implementation,
for safety promotion in their community; monitoring, and evaluation of promotive initiatives [15].
2. Long-term, sustainable programs covering genders Community itself play the leading role in Safe Community.
and all ages, environments, and situations; In order to evaluate the program and to show the evi-
3. Programs that target high-risk groups and environ- dence-based outcomes of Safe Community activities, the
ments, and programs that promote safety for vulnerable participation of hospitals, institutes, and universities has a
groups; significant impact in Safe Community movement. Osorno et
 43
al (2010) stated, that data from local hospital emergency de- increasing injury rates in the rest of Queensland sounds en-
partments provide a good basis for intervention and outcome couraging. Mackay Whitsunday Safe Community (MWSC)
evaluation [16]. According to Cho et al (2012), hospitals was established in 2000 in response to high rates of injury
play important role in risk assessment, health education, observed in the region. Injury control and safety promotion
community action, organisational development and advocacy activities were associated with a 33% reduction in injury
for policy to promote safety at a multi-level in the society. deaths. However, the researchers from Australia underli-
This can be accomplished most efficiently through collabo- ned “an Achilles’ heel” for sustainability of the program.
ration with diverse sectors within a community, including The productivity of MWSC was vulnerable to the changing
hospitals, public health professionals, policy makers, school policy priorities of external sponsoring agents and critically
boards, police departments, fire departments, citizens’ coali- dependent on the advocacy skills of its leaders [22, 23].
tions and others. For instance, since 2002, Ajou University In Asia, the Youth Park community was the first interna-
School of Medicine and Public Health in Suwon, Korea, has tional safe community in Mainland China. In Youth Park, the
introduced a Safe Community model to many countries in safety records for traffic, homes, production, public places
Asia, including Korea, Japan, China, Vietnam, and Thailand and “high-risk groups” have greatly improved, with the rate
[17]. Practical experience confirmed evidence basically by of injuries decreasing, and residents’ awareness of safety
research reveals significant importance of Safe Community increasing. In this Safe Community, all types of injuries
interventions. Academy, research institutions, medical scho- decreased by 34.2% [24]. In South Korea Safe Communities,
ols, hospitals, in addition, help to promote Safe Community the decrease in child and senior injury death rate was sta-
model and to heighten public awareness on safety issues. ted. Especially steep significant decline in the fall mortality
Successful Safe Community programmes. There are nu- rates among the elderly (from 32.0 to 11.7) was showed.
merous of successful working Safe Community initiatives The study on Gangbuk-gu Safe Community showed that
in the various continents of the world [18-27]. A number of Safe Community program might be a helpful programme
studies in Europe, mainly in Sweden evaluated the effect of for enhancing senior safety. The qualitative outcomes, such
Safe Community programs. Some of Swedish Safe Commu- as bringing the residents’ attention to the safety, significant
nities achieved a greater injury rate decrease in the whole active participation and coordination of stakeholders, should
population [18]. In Motala Safe Community (Sweden) a also be considered as important factors of the community-
reduction of 37% in injury rate between 1983 and 2008 (an based initiatives [25, 26]. In Iran, injury -related fatality rate
annual injury incidence decreased from 109.2 to 67.6 per significantly decreased in Kashmar Safe Community, when
1000 population) was recorded. In Motala Municipality, compared with control groups [27].
community-based injury prevention work according to the Positive outcomes of Safe Community programmes evi-
Safe Community model was successful and a cost effective dently confirmed effectiveness of the activities, reductive
way for reducing injuries in the local community. Over the impact on fatal and non-fatal injury rates, and on awareness
five years of sustainable work, the social economic costs rising among population toward injury prevention and sa-
were there by reduced by 21 million SEK (Swedish kroner) fety promotion. Successful projects at community level are
per year. Child injuries decreased by 26% in Motala and promising for health and safety promotion in community.
remained unchanged in the control community [19]. Activities at Safe Communities. Community based injury
In the USA, the Safe Community model has been applied prevention is focusing on activities, projects, and measures
mostly to traffic safety. It showed a decline by 25% of fatal in all areas and all environments with active participation
crashes (alcohol related - by 42%). Speeding and teenagers’
drink driving declined by half. An increase by 24% of seat Table 1. The areas of activities at Safe Community programmes
belt and child restrain use in the cars was presented at Safe
Communities [20]. According to recent studies, six million Typical projects New projects
Americans live in 25 Safe Community sites. Study in three • Child safety • First aid
Safe Communities confirmed that the Safe Community • Elderly safety • Alcohol consumption
model might be a promising approach to reduce injuries in • Traffic safety • Tobacco restrictions
• Home safety • Disaster preparedness
community settings. Using a pre-post intervention control
• Leisure safety • Food hygiene
design, there was found lower injury hospitalization rates • Occupational safety • Environmental health
associated with Safe Community accreditation [21]. • Sport safety • Water supply
In Australia, the consistent downward trend of injury • School safety • Healthy nutrition
indicators in Makay Municipality in when compared with • Violence and crime prevention • Physical activity
44
of everyone in a community. Since its establishment, the in Denmark, South Korea, US, and Hong Kong, run these
typical projects were carried out at Safe Communities. Pro- two programmes together with interaction among activities
jects targeted to the main areas of injury and safety. Along in the field of health and safety promotion.
with the common safety activities on injury prevention and
safety promotion, nowadays the new projects are included Conclusions
in Safe Community programs (Table 1). The international Safe Community module is an effective
Further concerns. Safe Community ideology helps to program for injury prevention, and safety promotion. Safe
get support from decision-makers, to create safe environ- Community program is comprehensive, sustainable health
ment, to involve local community in safety activities, and and safety promotion program with active involvement of
to coordinate those activities. The most important is that local community. Programme covers all genders, ages, envi-
this program empowers reduction of injury mortality, injury ronments, and situations, and targets vulnerable groups and
rate, and disabilities from injuries. The growing number high-risk environments. Reduced injury rate/morbidity, disa-
of designated Safe Communities around the world leads to bility, and mortality from injuries and violence, and improved
significant reduction in the numbers of injuries worldwide. quality of life, are the results of comprehensive sustainable
The public health sector, medical experts, and safety pro- preventive work at the community level. The subcategory
fessionals play the leading role in local community health Safe Schools are promising preventive programmes intended
education and safety promotion efforts. Health professionals to enhance child safety. Nowadays the interactions among
are most often the initiators of Safe Community program in activities in the field of health and safety promotion were
the community, and the leaders in practical activities. Mainly observed between Safe Community Programs and Healthy
they accomplish research and evaluate injury prevention City projects.
and safety promotion in community. Even an increase in
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 46
Saugios bendruomenės modelis yra ilgalaikė, tvari, koordi- darbo rezultatai bendruomenės lygmeniu. Subkategorija „Saugios
nuojama programa, pagrįsta partneryste ir bendradarbiavimu, ap- mokyklos” yra perspektyvios prevencinės programos, padedan-
imanti visas amžiaus, lyties grupes, įvairią aplinką ir situacijas. čios stiprinti vaiko saugą.
Saugios bendruomenės koncepcijoje padidintas dėmesys skiriamas Adresas susirašinėti: [email protected]
pažeidžiamoms grupėms ir didelės rizikos aplinkai. Programa do-
kumentuoja sužalojimų dažnį ir priežastis, taip pat turi vertinimo Gauta 2018-11-26
mechanizmus. Saugiose bendruomenėse vadovaujantis vaidmuo
tenka pačiai bendruomenei. Sumažėję sužalojimų skaičiaus/ser-
gamumo, negalios ir mirtingumo nuo sužalojimų rodikliai bei ge-
resnė gyvenimo kokybė yra kompleksinio nuoseklaus prevencinio

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