Emphasis on prevention
======================

* George Rakovich

I read with interest the editorial “Canadian health care is not universal.”1 This article brings to light some of the disparities in trauma care delivery between Quebec and the rest of Canada. There is no doubt that, as health care providers, we expect to have at our disposal the best possible tools for taking care of the sick and injured; without these tools we are invariably left with feelings of futility and frustration. Nonetheless, on a broader scale, prevention should certainly play a central role in any discussion addressing the issue of trauma care. This is particularly true when examining the cost-effectiveness of competing means of prevention and treatment and competing priorities. The economic and social costs of trauma are enormous.2 It is clear that high-risk behaviour, particularly alcohol consumption, is a major contributing factor to accidental injury and death.2,3 It has been shown that public education, legislation regulating speed limits and the enforcement of alcohol laws have had a substantial impact on lowering the trauma burden and are highly cost-effective.2 Yet we remain lenient and continue to accept aberrations such as the sponsorship of major motor-racing events by alcohol companies. There is no question that our mindset as a society still needs to evolve. When it comes to allocating our collective resources, trauma prevention through the targeting of high-risk behaviour such as speeding and impaired driving should remain paramount on our list of priorities.

## Footnotes

*   **Competing interests:** None declared.

## References

1.  Harvey EJ. Canadian health care is not universal. Can J Surg 2009;52:173.
    
    

2.  Peden M, Scurfield R, Sleet D, et al. World report on road traffic injury prevention. Geneva: World Health Organization; 2004.
    
    

3.  Canadian Institute for Health Information. Major injury in Ontario. Ontario Trauma Registry 2008 Report. Ottawa (ON): The Institute; 2009.