The 'Thunder of History' in Archives of the Theater and in the American Journal of Public Health Association 

My wife and I recently saw the theater play,  The Drowsy Chaperone, that begins when a die-hard musical theater fan plays his favorite archival cast album, and the musical magically bursts to life! The funny tale of a glamorous bride and her uproarious wedding day is complete with thrills and surprises.

It was great to relax and enjoy the play's thrills... and then some unexpected (sic) surprises: One of the songs, "Accidents Will Happen," and brief vignettes on the "Oops Girl"- wherever she went, she caused an "accident".

So, what was happening in the USA circa 1928, the setting for the original performance?  What was the 'thunder of history' on injury prevention - the flow on injury prevention which could not be modified regardless of what was done back then? Thankfully, that question, in part, was answered by our AJPH archives (if you haven't yet, do go to www.ajph.org and see all our Journal's archives) by searching the word 'accident' in the archive section.
        
From a section of the 1929 Journal, here's an injury control leadership historical archival sampler -  compliments and with the permission of the AJPH to our ICEHS Section to reproduce and distribute (with that  permission note):

American Journal of Public Health
and THE NATION'S HEALTH Vol. XI No. 2
Volume XIX February, 1929 Number 2
Our National Accident Problem
CHARLES B. SCOTT
President, Bureau of Safety, Chicago, Ill.
( Read before the Vital Statistics Section of the American Public Health Association at the Fifty-seventh Annual Meeting at Chicago, Ill., October 16, 1928.)

It was estimated that in the year 1927, there were 95,500 persons killed in accidents in the United States, an increase of 4 per cent over 1926. If the increase this year is as great, the number for 1928 will be almost 100,000. The probable loss of 100,000 lives in accidents in one year certainly constitutes an important national problem. Its importance is emphasized by a comparison with other causes of death. U.S. Bureau of the Census figures for 1926 indicate that in that year, there were only 6 diseases with higher death rates than the rate for accidents. These were heart disease, pneumonia, nephritis, cancer, tuberculosis, and cerebral hemorrhage. For men only, the importance of accidents is even more striking. In the year 1926 there were only two diseases among men which caused more deaths than were caused by accidents. These were heart disease and pneumonia. For women only, accidents stand 7th in importance among the various causes of death. We have not sufficient information to classify accurately these 95,500 fatalities in accordance with the place where the accident occurred. We do know quite definitely, however, that about 25,800 of them were the result of automobile accidents. This is an increase of 1,050 per cent in number of deaths since 1911, and an increase of 400 per cent in the death rate per 100,000 population since 1913. This information on automobile deaths is made available through the records of the U.S. Bureau of the Census. But to what are the remaining 70,000 deaths due? In addition to these motor vehicle accidents there are several other main groups of accidents on which our information is less complete. There are in addition to motor vehicle accidents other accidents that occur in public places but where a motor vehicle is not involved. In addition there are accidents occurring in industry and in homes. By a process which necessarily includes a great deal of guess work, statisticians of the National Safety Council estimate that about 25,000 of these 70,000 deaths occur in home accidents, another 25,000 in industrial accidents, and the remaining 19,700 in public (not motor vehicle) accidents. The seriousness of our accident problem is emphasized by a comparison with those in other countries. Whereas the death rate from accidents in this country in 1926, according to the U.S. Bureau of the Census reports, was 78.6, the accidental death rate in England and Wales was only 35.6, in Scotland 44.9, and in New Zealand 52.3. These are the only foreign rates available but I am sure that if the records of other countries were before us we should find the United States well in the lead on the question of accidents as a cause of death. Some interesting changes have occurred in accidental death rates over a period of years. In 1913, which is ordinarily taken as a normal pre-war year, the death rate from accidents was 85.5 per 100,000 population. This may be contrasted with the 80.5 per 100,000 in 1927, which is a drop of six per cent. The decrease has not been a consistent one, however, there being a gradual decline up to 1921 when the accidental death rate was 68.7 and an increase since that time. The decrease from 1913 to 1921 was 20 per cent and the increase from 1921 to 1927, 17 per cent. If the accidental death rate in 1927 had been as high as in 1913 there would have been 101,400 lives lost in accidents last year, or 5,900 more than the actual loss. If, however, the 1927 rate had been as low as that of 1921 the loss would have been only 81,500, 14,000 less than actually met death in this way. The death rates from accidental causes are by no means uniform in the various age groups. Children are particularly subject to the hazards of accidents. On the basis of U.S. Bureau of the Census data there are only two diseases which cause more deaths among children from 1 to 4 years of age than accidents. These are bronchial pneumonia, and diarrhea and enteritis. Between the ages 5 and 14 years the situation is even more severe, for we find that accidents cause more deaths than does any disease. No one will deny that tuberculosis takes a heavy toll of lives between the ages 10 and 20 years and yet we find that in the first half of this period accidents cause twice as many deaths as tuberculosis, and in the second half two thirds as many deaths as tuberculosis. These figures prove beyond any doubt that the national accident problem is indeed a serious one. Organized safety work began in industry. The National Safety Council was formed by industrial people who realized the importance of accidents both in their own plants and to society as a whole. Over the last 15 years interest in accident prevention work has extended to every phase of our national life, and therefore the scope of the council's activity has accordingly broadened. Throughout all this development it has again and again been proved that effective accident prevention work must be based upon complete data relative to accident causes. This is strikingly true in the industrial accident field, in which I have had most of my personal experience in accident prevention work. May I mention just one experience? Very complete records of accidents that were kept under my supervision of safety work in certain public utilities indicated that, over a period of years, only seven per cent of the accidents were charged to electricity. On the face of it this would not seem to be outstandingly important among all causes of accidents. However, further investigation of the records showed that these same accidents, while they amounted to but seven per cent of the total number of accidents, resulted in 75 per cent of the total number of fatalities. This was clear evidence of the importance of the electrical hazard, and of the necessity for more stringent requirements to combat it. This is mentioned to show that detailed information on the circumstances and causes of accidents should form the basis of effective prevention work. We are not sure how rapidly the industrial accident problem is being solved, because complete data on the subject are not available. We do know that in many instances industrial firms by careful analysis of their accident records, and persistent application of safety methods, have produced amazingly fine results. But at the very best the only information about accidents that can be obtained by industries will relate to industrial accidents only, and as a matter of fact it is only in industries covered by compensation laws that we have gotten very far along this line. We need data on industrial accidents that are not covered by compensation laws and we need data on the other 70,000 fatalities each year.

DISCUSSION
W. THURBER FALES, FELLOW APHA
State Registrar, State Board of Health, Montgomery, Ala.

Do read the discussion at www.ajph.org and if used, do credit the Journal, which gave us permission to duplicate and use in our work.

I as one historian-archivist in our field am happy to get the past right, let alone predict the future!  The roaring  1920's  was the historical platform for better data on injury causes to better shifting of American leaders' views from the increased toll of work site, motor vehicle and aeronautical accidents. The 'thunder of history' framework, however, was that 'accidents' happen and the major responsibility of the victim was to be careful. It would be many decades before the 1920's 'thunder of history' ended (by post WWII innovations, perhaps mostly) and a new framework of better injury reporting, more passive guards on work machinery, safety glass in car windshields, highway traffic lights - long after the NSC memberships' public safety programs ... and later to the very slow beginnings of airplane, automobile and consumer product safety engineering and practice systems.
      
So, The Drowsy Chaperone is a new entertaining Broadway musical with a flavor of the past for the present. As in the past 'thunder of history', is our current 'thunder of history' present in our values, activities and interactions on better injury prevention state and federal funding or in  the reduction of firearms injury, both during a time of severe national economics?

Darned if I know, I am not the injury prevention prophet from Delmar, NY; however, I am optimistic for our continued leadership leveraging for prevention, control and amelioration of the injury scourge.

But, what I do know after 45 years in injury prevention research, practice, education /advocacy is: the formative process is sometimes the outcome, and our job is to not, always (per Perke Avot), to complete the task but to move it forward. And our history can only show what problems others have had earlier and their efforts to improve our injury prevention and control leadership systems.

Keep plugging and spend some time also 'resharpening your saw' with avocation entertainments, so as to 'relight your fire' on injury control leadership!

Les

These opinions are mine alone.
copyrighted 2007 Les Fisher
Les Fisher, M.P.H

Safety/Leadership Consultant, (Archivist, American Public Health Association, Injury Control and Emergency Health Services Section - www.icehs.org - See my monthly newsletter commentaries and monographs at the members-only section of the web site, on the history of injury control leadership.