Safety and Safety Promotion : Conceptual and Operational Aspects

Safety and Safety Promotion :
Conceptual and Operational Aspects
Centre collaborateur OMS du Qu鶃bec pour la promotion de
la sɃcuritɃ et la prɃvention des traumatismes, RɃseau de
santɃ publique et MinistɃre de la Santȃ et des Services
sociaux du QuɃbec
WHO
Collaborating
Centre
on
Community
Safety
Promotion, Karolinska Institutet, Sweden
World Health Organisation
UNE VERSION FRANɃAISE DE CE DOCUMENT EST DISPONIBLE SUR DEMANDE
September 1998

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DǃpɃt lԃgal
BibliothɃque nationale du Quȃbec, 1998
BibliothɃque nationale du Canada, 1998
ISBN : 2-89496-085-9

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Safety and Safety Promotion :
i
Conceptual and Operational Aspects
This document was written by the following
ȃ From the Quebec WHO Collaborating Centre for Safety Promotion and Injury
Prevention:


-
Pierre Maurice*

-
Michel Lavoie

-
Renƒe Levaque Charron

-
Antoine Chapdelaine

-
HɃlɃne Bȃlanger Bonneau

Ƀ From the WHO Collaborating Centre on Community Safety Promotion, Karolinska
Institutet, Sweden :


-
Leif Svanstrƒm

-
Lucie Laflamme

-
Ragnar Andersson

փ From the World Health Organisation (WHO) :
-
Claude Romer
*
Correspondence :
Pierre Maurice
2400, d'Estimauville
Beauport (Quƒbec) CANADA
G1E 7G9
TɃl. : (418) 666-7000 poste 345 or 406
Fax : (418) 666-2776
E-mail : PMaurice@cspq.qc.ca

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Safety and Safety Promotion :
ii
Conceptual and Operational Aspects
TABLE OF CONTENTS
Page
Summary
.....................................................................................................................1
1.
Introduction
.....................................................................................................................3
2.
Main reasons to develop a safety promotion framework....................................................3
2.1
Safety is a basis human need.................................................................................3
2.2
Many safety issues are related to each other in many aspects.............................4
2.3
Safety means more than the absence of violent events or injuries........................4
2.4
Safety enhancement is a specific mandate for several agencies..........................4
2.5
There lacks a common understanding of safety.....................................................5
2.6
A safety promotion framework can be a good junction point between
concerned actors of a variety of sectors of the society....................................................5
3.
Main activities realised to develop this framework..............................................................5
4.
Framework
.....................................................................................................................6
4.1
Conceptual aspects of safety.................................................................................6
4.1.1
Safety definition.......................................................................................................7
4.1.2
Safety dimensions...................................................................................................7
4.1.3
Links between safety and health............................................................................9
4.1.4
Four basic conditions for safety..............................................................................9
4.2
Safety promotion....................................................................................................11
4.2.1
Definition................................................................................................................11
4.2.2
Operational aspects of a safety promotion approach...........................................12
4.2.3
Main difficulties to overcome in order to improve safety in a
community..............................................................................................................16
5.
Illustration of a safety promotion approach.......................................................................17
6.
Conclusion
...................................................................................................................18
7.
References
...................................................................................................................20

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Safety and Safety Promotion :
iii
Conceptual and Operational Aspects
Figures
Figure 1
The Two Dimensions of Safety...............................................................................8
Figure 2
Links Between Safety and Health...........................................................................9
Figure 3
Safety Promotion Process.....................................................................................11
Figure 4
Safety Diagnosis of a Particular Setting : Dimensions to Consider........................14
Appendix
Appendix 1
List of participants of the Internet discussion group
Appendix 2
List of participants of the QuɃbec Seminar (February 1998)
Appendix 3
List of participants of the Stockholm Seminar (May 1998)

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Safety and Safety Promotion :
1
Conceptual and Operational Aspects
Summary
This document presents the conceptual and operational aspects of safety1 and safety
promotion. More specifically, it proposes a framework to favour planning and implementation of
safety enhancement interventions in a community. It concerns unintentional injury, suicide,
violence and crime. These problems are tackled within a prevention and health promotion
perspective. It also favours a better integration of the most frequently used intervention models
designed to improve the safety of the population.
This framework was developed with the contribution of a number of intervening agents (that will
herewith be named "actors" in this text) and experts involved in safety enhancement activities
from many parts of the world. The numerous discussions held with them lead to a number of
consensus, which represent an essential part of the framework summarised bellow :
1.
Safety is a fundamental human right.
2.
Safety is a state in which hazards and conditions leading to physical, psychological or
material harm are controlled in order to preserve the health and well-being of individuals
and the community. It is an essential resource for everyday life that an individual and a
community need in order to realise their aspirations.
3.
There are two dimensions to safety : one is objective and assessed by behavioural
and environmental objective parameters and the other is subjective and appreciated
according to the feeling of safety of the population. Both dimensions can influence
each other either positively or negatively. It is therefore necessary to consider these
two dimensions to improve the safety of the population
4.
Safety is a pre-requisite to the maintenance and improvement of the well-being and health
of the population. It is the result of a dynamic balance that is established between the
different components within a specific setting.
5.
Attaining an optimum level of safety requires individuals, communities, governments and
others to create and maintain the four following conditions : 1) a climate of social
cohesion and peace as well as of equity protecting human rights and freedoms, at a
family, local, national or international level ; 2) the prevention and control of injuries and
others consequences or harms caused by accidents; 3) the respect of values as well as
the physical, material and psychological integrity of individuals ; and 4) the provision of
effective preventive, control and rehabilitation measures to ensure the presence of the
three previous conditions.
6.
Safety promotion is the process used at a local, national and international level by
individuals, communities, governments and others, including enterprises and non
governmental organisations, to develop and sustain safety. This process includes all
efforts agreed upon to modify the environment and structures as well as the attitudes
and behaviours related to safety. It is based on a multisectorial approach and includes
community enabling activities.

1
In French, the words ɂsafety˂ and ۂsecurity˂ are translated by only one word : ۂs˃curitɃɂ. In the
following English version, the authors made the choice to use only the word ۂsafety˂. In doing so, it
must be understood that the notions of ۂsecurity˂ are included in that of ۂsafety˂.

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Safety and Safety Promotion :
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Conceptual and Operational Aspects
7.
At least two types of processes can be used to promote safety in a community : the
problem-oriented process and the setting-oriented process. The two processes, though
quite distinct, are both complementary and essential. The problem-oriented process is the
search of specific solutions to problems considered one at a time. The setting-oriented
process consists above all in the assessment of the safety problems of a specific setting
in a global perspective and in the identification of an integrated set of solutions aimed at
improving the safety level of the population.
8.
The mobilisation of a community towards safety improvement requires the presence of
many critical factors, the most important being the following : 1) the existence of an
multisectorial committee responsible for safety promotion; 2) the implementation of a
programme covering all ages, environments and situations ; 3) the active involvement of
the local community network ; 4) priorities for action based on what the community feels
is most important ; 5) the capacity to assess the importance and causes of main safety
issues and problems ; 6) a special concern for high risk groups and environments ; 7) a
program planned on a long term rather than a short term basis; and 8) use of a wide
range of techniques to mobilise the population, its representatives and decision makers.
These eight statements provide a global and positive point of view in regards to safety and
safety promotion. It is useful to better understand and integrate the efforts made in a community
to improve its safety. It should also favour mobilisation of the population and multisectorial
partners aiming toward common safety goals, and thus should favour the effectiveness and
efficiency of interventions.

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Safety and Safety Promotion :
3
Conceptual and Operational Aspects
1.
Introduction
This document presents the conceptual and operational aspects of safety and safety promotion.
It proposes a framework to favour planning and implementation of safety enhancement
interventions in a community. This framework applies to unintentional injury, suicide, violence and
crime. These problems are tackled within the scope of a prevention and health promotion
perspective. It also favours a better integration of the most frequently used intervention models
designed to improve the safety of the population. More specifically, it proposes :
ۢ" a definition of safety and safety promotion ;
• a comprehensive approach to the assessment and promotion of safety and
• the main factors for the successful mobilisation of communities to enhance their safety.


This framework has been jointly developed by :

• the Quebec WHO Collaborating Centre for Safety Promotion and Injury Prevention ;

• the WHO Collaborating Centre on Community Safety Promotion, Karolinska Institutet, Sweden;
and

• the World Health Organisation (WHO).


This document is the result of a certain number of international initiatives such as the publication
in September 1989 of the « Manifesto for Safe Communities » (World Health Organisation, 1989),
the growing involvement of WHO in the field of violence prevention, and the sizeable
development of the Safe Communities network sponsored by the Karolinska Institutet (Sweden)
and its WHO Collaborating Centre on Community Safety Promotion. It originally stems from a
request by WHO in 1996, and a need stated in Johannesburg in October 1997 during the
SAFECOM-6 conference and during the Injury Prevention and Safety Promotion WHO
Collaborating centres meeting.


This publication is meant for all those whose vested interest is to improve the safety of the
population or to prevent injuries, violence and suicide. Those concerned may evolve within a
variety of fields such as public health, social sciences, justice, public safety, transport, sports
and recreation as well as in municipalities.


2
Main reasons to develop a safety promotion framework


2.1
Safety is a basic human need


Safety is an ever present concern within the population. Most individuals seek safety by all
means. Therefore safety improvement, as an explicit goal, can be a powerful mobilising force. It
is thus important to develop an enabling approach to facilitate the achievement of this goal.

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Safety and Safety Promotion :
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Conceptual and Operational Aspects

2.2
Many safety issues are related to each other in many aspects


Many safety issues share common risk factors. For example, firearms, medication, drugs and
alcohol, are all related to suicide, violence, criminality and non intentional injuries. Interventions
that take into account these risks and problems globally are liable to be more effective and
efficient.


On the other hand, measures to prevent one problem can worsen another problem. For example,
the decision to lower alcohol taxes to prevent criminal activities leads to a greater accessibility
and more consumption and therefore may have untoward effects on violence, suicide and non
intentional injuries. Such a decision must therefore be taken after considering its effects on all
aspects of safety rather than only one problem at a time.


Finally, a same organisation is often concerned by a set of safety issues. For example, the
solutions to road safety problems, criminality and violence all involve municipalities. Therefore, it
should prove timely and efficient for a municipality to consider all these problems and solutions
globally rather than on a one by one basis.


2.3
Safety means more than the absence of violent events or injuries


As we will see further in this document, safety is based in more conditions than only the
absence of violent events or injuries. Furthermore, safety includes a subjective dimension that is
important to take into account. This dimension is influenced by individual and collective
experience which will act upon the feeling of safety of the community. This observation explains
to a certain extent why, for example, in some communities the feeling of safety lowers while the
magnitude of safety problems as injury, violence or crime remains the same.


In addition, the reduction of violent incidents don’t necessarily lead to a proportional increase of
safety. For example, to reduce the number of aggressions in a park, it is possible to close it
down during the night. Also, to protect citizens living in a neighbourhood, walls can be erected
all around to restrict its accessibility and alarm systems can be placed in all homes. In such
cases, violent incidents are prevented by either reducing the opportunities or by placing
protective measures. It is sometimes the only short term solutions feasible. However a
fundamental safety problem remains despite such efforts. Indeed, those measures don’t provide
any long term solutions to violence. They are palliative and temporary. The assailants will
obviously find new ways to avoid them resulting in an escalation of the protective measures and
devices used. These finally turn out to be a concrete manifestation of existing safety problems.
Moreover, many of these measures end up jeopardising the population’s right to move around
freely and accomplish their activities peacefully.


Thus, safety improvement of the population must take into account several aspects. A
framework allowing a better integration of all these aspects within a comprehensive approach
can be helpful for those whose role is to enhance the safety of a population.


2.4
Safety enhancement is a specific mandate for several agencies


Whoever works in safety improvement activities knows the indispensable contribution of a set of
sectors such as health, public safety, transport, justice, sports and recreation, housing, etc.,
when the time comes for creating and implementing interventions. These sectors generally have
among their mandates, the enhancement of the population’s safety. That is why a framework on
the concepts of safety and safety promotion can be a helpful tool for them.

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Safety and Safety Promotion :
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Conceptual and Operational Aspects

2.5
There lacks a common understanding of safety


Much confusion exists concerning the concept of safety. For some, this concept refers only to
the prevention of crime and violence ; for others it refers more to a feeling of being out of danger
than to an objective state, or it refers to the satisfaction of basic needs (food, shelter, clothing,
etc.). These interpretations do not always include injury prevention. In fact, the concept of
“safety” is quite difficult to understand in all its dimensions (physical, social, psychological, etc.),
and therefore difficult to promote.


Having a common understanding of safety should favour a better co-operation between the
variety of disciplines and sectors concerned, and consequently will diminish the state of isolation
they are in. It should stimulate the development of initiatives that can reduce the occurrence of a
given problem, and can improve the safety of the population in a comprehensive perspective.
This can only help to create a positive vision of safety as a value worth promoting in our
communities.


2.6
A safety promotion framework can be a good junction point between
concerned actors from a variety of sectors of society


Many approaches are used in the field of safety promotion and injury prevention. These
approaches attract different followers, often based on their occupation, sector and country of
origin. Each group uses a specific vocabulary and may have very different ways of
understanding reality, as well as of designing interventions and putting them to place. For
example, in order to prevent violence in a neighbourhood, the police department might use
repressive measures, the urban planing department will favour environmental measures to avoid
opportunities for assaults and the recreational department will put forward a program to foster
activities for youths. As for the actors from other sectors, they could favour programs aimed at
preventing violence by implementing measures focused on early childhood. Yet, all are working
toward the same goal. However, the absence of a common thread among these models of
intervention results in misunderstanding among various groups and makes it difficult to
understand each group's actions in light of the realm of possible interventions (Else, Walker,
1978 ; Hayes, Carter et al., 1996). When safety actors work in isolation, it compromises the
achievement of goals that they may share. A common framework for these players can
therefore represent a useful common thread among the various models used. It also favours
collaboration between actors and a better co-ordination of their interventions. The mobilisation of
all partners involved in safety will then be facilitated.


3.
Main activities realised to develop this framework


To develop this framework a number of activities were held between June 1996 and May 1998.
The following must be mentioned :

• A literature review regarding safety and safety indicators within the community was carried
out (Levaque Charron, Cardinal, Lavoie, Maurice, Paradis, 1998).

• A document on the conceptual and operational aspects of safety and safety promotion was
drafted and published (Maurice et al, 1997). This document was presented and discussed
during several international events : in June 1997 in Québec, during the International Safety
Promotion and Injury Prevention Training Session and the 2nd Injury and Accident Prevention
French Speaking Network International Seminar, and in October 1997 in Johannesburg,
during the Sixth International Conference on Safe Communities.

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