The United States spends more on health than any other country that is economically comparable, but sees a moderate return on this investment. In my last report, I argued that this is because the United States is investing mostly in medicine and curative care, the social, economic and environmental determinants of the health account – factors such as good education, housing, security air, water and nutritious food. A deeper investment in such factors can help create healthy communities and prevent diseases before they occur.
It is important when clarifying the status of this investment to be a change towards stopping the disease before it starts, it does not mean throwing away the resources of doctors and hospitals – the first line of our defense in the incidence of the disease. The history of fire prevention in the United States can be the best example of how prevention should not come at the expense of treatment.
Fire fighting has a long history, dating back to Roman times. However, modern fire prevention is largely the result of the tragedies that occurred on October 8, 1871. That was the day both the Greater Chicago Fire and the Wisconsin Peshtigu exploded. The Great Fire of Chicago has killed more than 300 people, displaced 100,000 people, destroyed more than 17,400 buildings and burned more than 2,000 acres. Peshitigu Fire – the worst wildfires in the history of the United States – destroyed 16 cities and claimed more than 1,000 lives.
These fires were so devastating that attitudes toward fire safety in the United States changed. Shortly after the Great Chicago Fire, the city began celebrating the event with celebrations. On the 40th anniversary of the shooting, North American firefighters decided to formalize the event, using today to promote fire prevention education. Beginning in the 1920s, Fire Prevention Week was established annually from Sunday to Saturday, October 9 and continued to maintain the oldest health and safety record. As it has been called intensive a focus on prevention, with firefighters a prominent role in these efforts, in the media during the twenties of the twentieth century, the Declaration call more to stop the fires before they start.
Since then, fire prevention has become an important part of how we see fire safety in the United States and we have made a clear difference in the number of fire deaths and injuries. In 1977, there were 723,500 domestic fires in the country, with 5865 civilian deaths and 21,640 injuries. In 2015, these figures were reduced to 365,500 home fires, with 2,650 civilians killed and 11,075 injured.
The success of prevention has not been limited to reducing fires in the home. Between 1980 and 2013, car fires decreased by 64% and fires in buildings fell by 54%.
Why was prevention so effective? Most fires are due to correctable human errors or lack of safety systems, such as smoke alarms and machine guns. For this reason, preventive steps such as fire education and the installation of smoke detectors can do much to create a safer environment. Simply adding smoke detectors, for example, can halve the risk of death in a home fire. Fire education can help to discourage unsafe behavior and encourage individuals and families to develop a means of escape in case of fire.
It is crucial that the success of these efforts has not been achieved at the expense of people and organizations that fight fires when prevention does not occur. On the contrary, as we reduce the number of fires, the number of firefighters increases. Although there are 50 percent fewer home fires than 30 years ago, there are more than 50 percent of professional firefighters. 237,750 in 1986 to 345,600 in 2015.This increase coincided with an increase in public spending on local fire protection. Adjusted for inflation, spending increased 170 percent between 1980 and 2014, going from $ 16.4 billion to $ 44.2 billion.
The history of fire prevention in the United States shows that the increase in prevention does not require the deterioration of treatment. It is clear that our investment in reducing fires by creating an environment in which less than the probability of occurrence has achieved success, but this success does not change our commitment to maintain a network of professional firefighters, ready to respond in emergency case. On the other hand, we have been successful in integrating the preventive approach of the work.