Rethinking Injury Events. Explorations in Spatial Aspects and Situational Prevention Strategies

Doctoral thesis, 2018

This dissertation employs a holistic approach to injuries in everyday settings. It examines spatial aspects of adolescents’ injury events in residential situations, school situations, and suicidal situations, seeking to throw light on any reciprocal influence between situated activity and the physical environment in such events. Thus far, research has generally neglected to pay sufficient attention to everyday injuries and the more mundane sites where they occur. Previous studies on the topic have, moreover, been predominantly mono-disciplinary. Due to the complexity of injury research more broadly and injury prevention more specifically, this dissertation makes a conscious effort to go beyond such limitations. Applying an interdisciplinary and transdisciplinary focus, it also aims to contribute to research on social sustainability more in general. 
 
The more theoretical aspects of the research are geared to providing a better understanding of injury events as something explicable and situated, that is to say, as neither random nor unpreventable. Towards this end, core concepts of architectural research are brought to bear on the interrelationship between humans, objects, and contexts (cf. Love, 2002), defined for the purposes of this dissertation as socio-spatial practice. From this perspective, injury events are then looked at as something resulting from the convergence of factors addressed by the key concepts just named, as something caused by elements traceable to routine or situational activities (cf. Cohen & Felson, 1979; Wikström, 2011). Analysing injury events within this conceptual framework, the causal mechanisms and emergent processes behind injury events can be not only identified, but also prevented, through the use of situational prevention strategies. What this implies is the translation of, mainly, the Crime Prevention through Environmental Design (CPTED) approach into Injury Prevention through Environmental Design (IPTED). The research here is conducted using a mixed-method approach producing qualitative findings and quantitative data, so as to bridge the gap between the “how” and the “why” (cf. Clarke et al., 2015:13f.; Katz, 2001). 
 
The results put forth in this dissertation suggest situational prevention specifically aimed at spatial aspects to be a promising approach to injury prevention, having the capability to reduce the occurrence of injury events. In private residential settings, however, the strategy showed itself to be more limited in its efficiency, being more effective when applied in semi-private settings such as building entrances/ lobbies. A still more effective context for it was found to be institutional settings: in them the spatial aspect appeared to be of great importance in relation to injury situations and the degree of visibility. In schools, for instance, the results pointed out to a close relationship between the injury situation, the spatial organization, and the social organization. In such settings, certain injuries tended to cluster spatially due to the organization of day-to-day activities. Finally, the results suggest that also suicides and suicide attempts in semi-public and public spaces could be significantly reduced through carefully thought-out environmental interventions. At the same time, there remains a need for further analysis of the events and places involved in suicides and their attempts, to fully understand who commit them in these settings and why.