Falkoping, Sweden, ten years after: still a safe community?

Abstract The Falkoping Accident Prevention Program (FAPP) is based in Skaraborg County, Sweden. An injury register was started in 1978 and intervention began in 1979. Three years later the rate of injuries had fallen by 23%. This led to the World Health Organization designating Falkoping as a ‘Safe Community’. Is this title still appropriate? The program has been followed over the period from 1978 to 1991, using indicators of process as well as outcome. Since 1983 the outpatient injury rate has levelled off and the inpatient rate shows an average annual increase of 8.7% for females and 4.9% for males, which is significantly higher than the increase for Sweden, which is 2.3% for females and 0.5% for males. Thus, for injuries seen in either ambulatory or hospital settings, it seems that the effect of the early phase of the program was a lasting one, but for injuries admitted to hospital the effect was temporary. The onset of the increase by the end of 1982 coincides with the break-up of the cross-sectoral o...