Stop Calling Them Accidents

Preventable injuries are preventable. But the rest of the story is that the poor have a much higher preventable death and injury rate than the affluent.

Since 1992, the rate has been rising. This is the aftereffect of President Ronald Reagan dismantling the social safety net, and him and every president who would follow defunding and defanging the regulatory agencies we created to keep us safe.

Tort lawsuits can help, although only after the worst has occurred. But they can prevent things from happening again and again. Accidental death rates in anesthesiology plummeted after hospitals were sued and changed their practices. The problem is, so-called tort reform has deeply disempowered individuals from suing. The effort to limit suits has gone way too far.

The workers’ compensation system has also helped. People used to die at work in truly insane numbers. In the past that only cost you as much as hiring a replacement. Now it costs them more to have a high accident rate.

I like the Swiss cheese model as a way to understand how risk leaks through. Each layer of protection has holes but if you have enough layers, nothing can get through. Some of our layers of safety depend on who we are. Which is why Black people are more likely to die in house fires. It comes down to what housing you have. That could be a hole in your Swiss cheese.