Safety Lessons From the Morgue

Eric Ogden for The New York Times

Susan P. Baker, an epidemiologist who has spent more than four decades trying to find out why people are dying and what could be done to stop it.

On a bright, chilly morning in February, Susan P. Baker sat in her fifth-floor office at the Johns Hopkins University Bloomberg School of Public Health in Baltimore, staring at her computer screen. She had just completed a search for the word "sightseeing" in a federal database of U.S. aviation crashes between 2000 and 2010. Now she was scrolling through a seemingly endless list of grim case histories of people who were killed or injured when their sightseeing aircraft or balloon crashed.

Richard Holden/Getty Images

Susan Baker demonstrating a car seat in 1983.

A month before, she read a news story about the crash of a tour helicopter in Nevada. Five people died, including a couple celebrating their 25th anniversary. "It made me sad and angry," she recalled. "Such senseless deaths!" So Baker, an epidemiologist, did what she's been doing for more than four decades. She decided to find out why people were dying and what could be done to stop it.

Working with Sarah-Blythe Ballard, a doctoral candidate and Navy flight surgeon, Baker prepared an abstract and sent it to the Aerospace Medical Association. When it's finished, the article will delineate the number of fatalities for each mode of sightseeing flight, including balloon, helicopter and fixed-wing; describe the circumstances that led to each crash, like encounters between hot-air balloons and power lines; and offer suggestions for reducing the risk of a crash — for example, increasing training for pilots on landing in unfavorable wind conditions and avoiding power lines. Then, if everything goes the way it usually does when Baker publishes her work, the article will be picked up by the media, putting pressure on the businesses that run sightseeing flights, as well as the legislative committees and agencies that oversee their operations, to improve the way these flights are conducted. Over time, the hope is, fewer people will die in these sorts of accidents.

Baker has had a hand in more than 250 such research papers, as well as her nearly 40 monographs and textbook chapters and 5 books. She has endlessly lobbied, in person and in print, for gun control and air bags, motorcycle helmets and home sprinkler systems. She has fought to put the discipline of injury prevention on the nation's public-health agenda, leading to the creation of the National Center for Injury Prevention and Control and nearly a dozen injury-research centers at universities and hospitals around the country.

Dr. Gary Smith is the president of the Child Injury Prevention Alliance, in Columbus, Ohio. He is also one of the hundreds of today's injury-prevention leaders who decided on their life's work while sitting in Baker's classroom. "Sue is to injury prevention what Einstein was to theoretical physics," he says. "There were people there before them, some remarkable people, but these two changed everything."

At 82, Baker is still pursuing the grisly facts behind deadly statistics. More than 120,000 Americans die from accidental injuries each year, and Baker believes many of them can be saved. As she explains it, "To say that a car crash is an accident is to say it's a matter of chance, a surprise, but car crashes happen all the time, and the injuries that people sustain in those crashes are usually predictable and preventable."

When Baker started her career in the 1960s, public health was still mostly about preventing disease, not injury. Tuberculosis and influenza killed tens of millions in the first part of the 20th century. To the extent that people were injured or lost their lives in accidents at home or at work or on the roads in between, corporate and government leaders generally viewed that as a cost of doing business, an unfortunate accompaniment to progress. It was the responsibility of the individual to keep himself safe from these dangers.

That focus on individual behavior led to the licensing of drivers and to decades of safety slogans in schools and factories and on the highways. By the 1930s, Burma Shave's billboards were ubiquitous: "Keep well/To the right/Of the oncoming car/Get your close shaves/From the half-pound jar/Burma-Shave." Over the years, though, it became evident that education had its limits, and engineers began examining the environments in which most injuries occurred: homes, workplaces and roadways.

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