—Dr Blackman suggests that the public health paradigm may not be appropriate for motor vehicle crashes and may not be applicable to firearm injuries. We think the public health paradigm is useful for organizing information and identifying prevention strategies along logical and consistent lines. This epidemiologic triad helps us view deaths and injuries as resulting from interactions of the host, vehicle/ agent, and environment. Deaths and injuries can be reduced by changing the relationship of these factors, and the reduced speed limits and improved emergency medical responses that Blackman mentions are good examples of how changes in the environment affect motor vehicle crash injuries.Changes in vehicular design, including air bags, seat belts, and crashworthy occupant compartments, and constructive changes in human behavior by reduced drunk driving have further contributed to the reduction in motor vehicle crash deaths and form the second and third parts of the triad.
Hargarten SW, O'Brien M, Quebberman E, Karlson TA, Hancock J. Firearms and Fatalities-Reply. JAMA. 1996;275(22):1724-1725. doi:10.1001/jama.1996.03530460027017