Understanding the Cost of Injury

Latest article by Dr Robert Long, covering the real consequences of injury. Again, no apologies to the Zero Harm fans! If you liked this article then you should read the whole series: CLICK HERE. I highly recommend you check out Rob’s new book “RISK MAKES SENSE”

Understanding Injury Cost and Flow on Effects

When people make a trade off in risk there is rarely much consideration of things going wrong and consequences. The human tendency to overestimate ability and underestimate consequence seems to be ‘hard wired’ into our DNA. We take risks optimistically; our eyes and mind are fixed on the benefit of that trade off. What is amazing is that we assess dozens of things in that millisecond of implicit knowledge when we make that ‘gut’ judgment. Wherever happens in our subconscious in that millisecond ‘informs’ that decision.

Trade offs in risk and shortcuts are attractive; denial of that attraction facilitates ‘head in the sand’ safety culture. When one is intimidated by the cult of zero, this denial and suppression of reality is normalized. Rather than discuss the realities of risk or managing trade offs, the zero code fosters ‘risk reality blindness’. ‘Zero talk’ suppresses the imagination of risk. ‘Talk’ about mistakes, risk and getting things wrong is anathema talk in the zero cult. Any discourse that suppresses risk imagination is simply dangerous. We should be ‘priming’ the subconscious with ‘risk thinking’ not suppressing it.

It’s hard to imagine consequences when one lacks the experience associated with risk failure. Imagination and creativity are fundamental to making good or poor risk trade offs. So it’s often a shock to people when they experience a serious injury and learn of the many ‘flow on’ effects. The conversation goes something like this: ‘I had no idea this could happen’. In order to help your risk imagination let’s discuss a few injury flow on effects:

Physical Effect

Depending on the age of the person and the seriousness of the injury, recovery is rarely complete. There always seems to be some lingering after effect which returns in middle age and older. Most injury has some sense of permanence.

Medication and Medical Dependence

Often severe injury creates a life-long dependence on medication or self-medication dependence if psychological injury is associated with the incident. Sometimes this self-medication shows up in alcohol or substance abuse.


The rehabilitation of injured workers is costly in a variety of ways. For those with long term injury and low prospects of returning to the same work new psychoses develop. Eventually the physical injury becomes secondary to a host of other mental health issues and dependencies. Any person who requires more than three to six months off work to recover from injury is at risk of this flow on effect.


Often an injury results in a loss of mobility and independence, you become dependent on others for transport and fundamentals of living.


Psychological Effect

The number of psychological effects which flow from physical injury are countless. Most injury involves some aspect of trauma and loss, even if only the loss of some minor capability like being able to do up shoes or put a bra on. Trauma and loss lead to various forms of stress, denial and anxiety. If these are accentuated they actually poison our immune system and make us more sick. Being out of work increases the risk of depression.

Social Effect

Injury affects social mobility and relationships, the loss of work engagement and being stuck at home is not all its cracked up to be. There is no great benefit in loneliness and lack of community. Initially people will come and visit but in time only a few family members will provide extended support.

Family Effect

Families bear the brunt of injury flow on. Generally, someone close to you will have to give up something, career or personal goals for you. The more debilitating the injury the more this sacrifice of love and dependence is amplified. This creates its own resentments and flow-on for families sometimes fracturing families apart.

Economic Effect

All injury is costly in the short and long term. There are many hidden aspects of injury that are not covered by insurers and employers. All injury hits you in the hip pocket.

Employer Effect

Of course while someone is injured the work has to continue, so the employer and insurer pays out for your injury, recuperation and replacement. Often fellow workers shoulder the burden of extra work while the new person is adapting to your role. This creates resentment and increases projected blame on the worker for their mistake.

Reframing Effect

Psychologically it is hard to cope with the fact that your injury was something that happened out of your control, whether caused by another or by your own unconscious.

The Insurance Effect

Insurance companies assess injury as a liability; premiums increase as they too assess their risks. When it comes to insurance management of long-term injury and rehabilitation things can get quite nasty. All sorts of tactics are employed to get the long term injured ‘off the books’. Reclassifying injury, using ‘own’ doctors’ and a host of other strategies are used by insurance companies to get the long term injured out of their system. This too has painful an extensive psychological flow on effect.

So there you go, just imagine the implications of these things for you next risk trade off. Thinking and talking about these outcomes are important for our discourse in risk. The repetition of these conversations help prime these factors into our subconscious and may just get into that implicit knowledge and change the outcomes of that millisecond decision.

Author’s Resource Box

Dr Robert Long

PhD., (UWS) BEd., (USA) BTh., (SCD) MEd., (Syd) MOH (La Trobe), Dip T., Dip Min., MACE, CFSIA.

Executive Director – Human Dymensions Pty Ltd

Rob has a creative career in teaching, education, community services, government and management.

Rob is engaged by organisations because of his expertise in culture, learning, risk and social psychology. He is a skilled presenter and designer of learning events, training and curriculum.

Web Link: www.humandymensions.com


Dr Rob Long

Dr Rob Long

Expert in Social Psychology, Principal & Trainer at Human Dymensions
Dr Rob Long

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Dr Rob Long
PhD., MEd., MOH., BEd., BTh., Dip T., Dip Min., Cert IV TAA, MRMIA Rob is the founder of Human Dymensions and has extensive experience, qualifications and expertise across a range of sectors including government, education, corporate, industry and community sectors over 30 years. Rob has worked at all levels of the education and training sector including serving on various post graduate executive, post graduate supervision, post graduate course design and implementation programs.

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