Journal Issue: Children, Youth, and Gun Violence Volume 12 Number 2 Summer/Fall 2002
Rationale behind the Product Safety Approach
Gun violence prevention can be considered a subset of injury prevention, a discipline that for several decades has studied the most effective methods for reducing the incidence of injuries. A basic tenet of injury prevention, supported by these studies, is that attempts to modify the behaviors of individuals so that they act more safely have not in themselves proven adequate to address most injury problems. Changing the design of products has been more effective in reducing risks of injury. Two examples of the differences in effects between product modification and behavior modification are childhood poisoning prevention and motor vehicle safety.
Childhood Poisoning Prevention
Childhood poisoning by medications such as aspirin has long been recognized as a serious injury problem. One way to address the problem is to teach parents and caregivers that medications should be stored in a manner that is inaccessible by young children. The youngsters themselves also could be taught that certain products are poisonous and must be avoided. This was the point of the "Mr. Yuk" campaign, in which a logo was designed with the hope that young children would recognize it and, through training, learn not to touch products bearing it. When this approach to protecting young children by modifying their behavior was tested, however, it proved flawed. In one study, young children who had been instructed not to play with items bearing the colorful Mr. Yuk label preferentially played with those items, compared to children in a control group who had not received the educational intervention.1
In contrast, research has shown that changing the design and packaging of medications can effectively prevent childhood injury. The use of child-resistant caps for medications and poisons, along with limits on the number of pills in a single vial for many over-the-counter medications, saved the lives of an estimated 460 children under age five between 1974 and 1992.2
Programs designed to teach adults to alter their behaviors for the protection of their children, such as by locking away poisons3 or even guns,4,5 have also shown less than satisfying results. (See the article by Hardy.) Sometimes, even when adults do change their behaviors to protect their children, it is not enough to prevent tragedy. For example, one of the recent school shootings demonstrated the limitations of adult behavior-oriented safety interventions. In March 2001, a 15-year-old student at Santana High School in Santee, California, used a handgun to shoot and kill 2 of his classmates and wound 13 more. The boy's father reported that the handgun came from his own locked gun cabinet.6 Apparently, his son could still gain access to the firearms.
Motor Vehicle Safety
The field of motor vehicle safety provides other examples of the relative benefits conferred by modifying a product rather than promoting behavioral change. In the mid-1960s, the U.S. public and Congress realized that continued efforts to enhance the skills of drivers were inadequate for reducing the toll of highway fatalities. Attention was therefore turned to the vehicle, with the assumption that crashes would still occur and that modifying the design of the car could alter human consequences of these crashes. The forces of legislation, regulation, and litigation were thus used to mandate collapsible steering columns, seatbelts, energy-absorbing vehicle frames, and other physical modifications to cars. These changes have been credited with saving hundreds of thousands of lives.7 Although efforts to enhance the safety skills of drivers were not (and should not be) abandoned, product modification proved effective in reducing highway fatalities.
As the childhood poisoning prevention and motor vehicle safety cases illustrate, behavioral interventions alone are not enough to reduce injuries and death; product safety modifications also play a key role. Unfortunately, this lesson has yet to penetrate many gun violence prevention efforts. For example, some advocates for gun safety have recently argued that a "code of responsibility" for gun owners is needed, whereby owners would voluntarily pledge to keep their guns stored safely.8 The plan for achieving this change in adult behavior is through a public education program similar to one in which vehicle occupants were implored to "buckle up" decades ago in the field of motor vehicle safety. Education campaigns like these have fallen far short of their mark, leaving occupants unprotected and subject to severe injuries or deaths in crashes. Not until legislation in the United States mandated seatbelt use did the rate of use increase materially and the death rate fall.