Injury and Violence Prevention

Angela DiazDanielle Gemender

Janet HerndonCassie LanglessMarc Manucal

Jena MillerJP Millete

Christine NavarroKayla Rogowski

Injury and ViolencePrevention

Health People 2020

• Objective:Reduce Unintentional Injury Deaths

– “Healthy People 2020 provides science-based, 10-year national objectives for improving health of all Americans” (Healthy People, 2012).

– Healthy People 2020 determines the goals and objectives of health in the community, so that problems or complications, which can be costly, can be reduced

Injury Prevention

• Goal: Prevent unintentional injuries and to reduce their consequences (Healthy People, 2012)

• Injuries can be both unintentional and intentional

• Most injuries are predictable and preventable

Why is injury prevention important?

• Injuries are the leading cause of death for Americans ages 1-44 (Healthy People, 2012)

• More than 180,000 people die from injuries each year.

The status of the problem in other nations

• 3.9 million unintentional deaths worldwide in 2004• It is difficult to obtain accurate data in areas of the

world with weak data infrastructure• 91% (3.5 million) deaths occurred in Low-Middle

Income Countries• The regional death rate was highest in Southeast Asia

(80 per 100,000)

The status of the problem in other nations

• Road Traffic Injuries are leading cause of unintentional death (1.3 million deaths per year). Although lower in High Income Countries, 130,000 deaths were still attributed to RTI’s in Europe.

• Falls are the second leading cause and account for 424,000 deaths in 2004. Particularly accounted for the elderly older than 70 years old.

• Third leading cause of unintentional deaths is drowning and account for 390,000 deaths annually. 75% of drowning deaths occur in LMIC and children under the age of 5 have the highest mortality rates. The highest death rates among children occur in the Western Pacific (13.9 per 100,000) and Africa (7.2 per 100,000)

The status of the problem for the United States

• National unintentional injury deaths for the year of 2009 include roughly 37 deaths per 100,000 people (Health Indicators, 2009). – If this rate continued, with a US population today of about

314,653,370 people, roughly 116,422 people will die of unintentional injury in the year of 2012 (United States Census Bureau, 2012).

• Top three unintentional injuries reported in the year 2010 for the nation include motor vehicle accidents (28.1%), poisoning (27.6%), and falls (21.7%).

• These three type of injuries accounted for 92,635 deaths in 2010 (Center of Disease Control and Prevention).


• Motor vehicle accidents– Decrease in incidences within the past 20 years– In 1990, the rate of motor vehicle accident deaths

was 17.9 per 100,000 population – In 2000 the rate was 14.9 per 100,000 population– In 2009 the rate had decreased to 11.0 per

100,000 population (United States Census Bureau, 2012).


• Poisoning– Poisoning rates have increased in the past years. – Mortality rate for poisoning has increased by

128% from 2000 to 2009. – According to research this can mainly be

attributed to lack of knowledge regarding prescription medications leading to overdose (Rockett, et al., 2012).


• Falls– Most affected by this injury = older population greater than

55 years old. – In 2000 the rate of falls for the population ages 55 to 74

years old was 11.9; however in 2009 the rate of falls for this population was 14.3. • This is an increase of 2.4 per 100,000 population.

– In 2000 the rate of falls for the population ages greater than or equal to 75 years old was 32.0; however in 2009 the rate of falls for this population was 52.1. • This is an increase of 20.1 per 100,000 population (Rockett, et al.,

2012).

The status of the problem in our community

• In Virginia– Injuries are the 3rd leading cause of death– 38,211 deaths were caused by an injury over the

last decade– Unintentional injuries were the top cause of death

for residents ages 1 to 34 years– Ranked 36th out of the entire nation for the

highest unintentional injury death rate between the years 2000 and 2007

The status of the problem in our community

Unintentional Injuries• The leading causes of unintentional injury deaths in Virginia were due to

– Motor Vehicle Accidents– Poisoning– Falls

• Other common injury deaths– Suffocation– Fire/Flame– Drowning– Natural/Environment– Other, specified or unspecified

Leading causes of unintentional injury deaths

• Motor Vehicle Accidents– Accounted for more than 1/3 of all unintentional injury deaths for Virginians between the ages of 5

and 24– Occupants were more likely to die or be hospitalized– Majority of highway accidents between 2006 and 2011 were due to speeding and reckless driving– Distracted driving is becoming more of a public concern

• Ex: taking eyes off the road, eating while driving

• Poisoning– Virginia Poison Control Network received a total of 92,346 incoming calls in 2008

• More than half were related to human poison exposures

– Unintentional poisonings accounted for 81.7% of the total poisonings• General poison exposure, medications errors/misuse, adverse reactions & environmental poisonings

– Children at high risk

• Falls– Leading cause of unintentional injury death for residents ages 75 years and older– Top cause of injury hospitalization

• Hospitalization rate 42x > death rate (2000-2009)

National trends• Motor Vehicle Injuries– Last 10 years:

• 2004 – approximately 40,000 fatalities and a little under 3 million injuries

• 2008 – approximately 35,000 fatalities and 2.3 million injuries

• 2010 – 32,885 fatalities and approximately 2.1 million injuries

National trends

National trends

• Poison Control– 2002 – approximately

10 deaths per 100,000 population

– 2004 – approximately 12 deaths per 100,000 population

– 2008 – approximately 13.5 deaths per 100,000 population

National trends

• Falls– 2005 – 15,800 people

65 and older died from injuries related to unintentional falls

– 2009 – falls resulted in more than 25,000 fatalities

– 2010 – falls resulted in 25,998 fatalities

Virginia trends

• Motor Vehicle Injuries– 2005 – 947 traffic

fatalities– 2009 – 757 traffic

fatalities– 2010 – 740 traffic

fatalities

Virginia trends

• Poison control– 2002 – approximately

7.9 per 100,000 poison related deaths

– 2004 – approximately 8 per 100,000 poison related deaths

– 2009 – 769 poison related deaths and 7,417 hospitalizations

Virginia trends

• Falls– 2003 – 398 fall related

deaths and 13,740 hospitalizations

– 2007 – 461 fall related deaths and 18,671 hospitalizations

– 2008 – falls caused 19,089 hospitalizations

Local Programs

• Motor Vehicle• Child Passenger Safety Program

– Promotes proper safety seat restraint use for children until they transition to the vehicle safety belt, increases risk perception and correct usage of child restraints among parents and caregivers through outreach and education, provids proper installation education and addressing the barriers that prohibit access to safety devices.

• The Program provides:– Free child safety seats and booster seats to income eligible families– Safety Seat Check Stations and Events– Information on Virginia's Child Passenger Safety Laws– Safety Seat Installation Video Tutorials (YouTube)

Local Programs Child Passenger Safety Program• Agencies that serve the residents of a particular county or city for distribution.• Free child safety seats and booster seats are available for income eligible

children. Parents, foster parents and legal guardians of children who reside in Virginia may also apply.

Local Programs Child Passenger Safety Program• Safety Seat Check Station or a Safety Seat Check Event• Free hands-on help from a Certified Child Passenger Safety Technician to learn

how to install their safety seat,• Interactive and takes 20-30 minutes

Local ProgramsSafe KidsLed by: Children's Hospital of RichmondWhat they offer:• Child passenger safety technician certification course• Summer Safety Fair• Click It or Ticket• Child Passenger Safety Refresher Course

Local Programs Other injuries: Fire• Fire departments offer free smoke detectors

upon request• Virginia Beach Fire Department Clown (Buckets)

teaches at schools about fire safety

Successful Programs

Motor Vehicle accidents• Arizona “Battle of the Belt”– Increased seat belt use from 58% to 98% on high

school campus

Successful Programs

Poison• California Poison Control system (CPCS) in an effort to decrease

accidental poisoning in children distributes educational packages in English and Spanish to all California head start state preschools as well as state and federally funded Women, infants, and Children(WIC) programs

• North Carolina Pediatric Poison prevention project was design to conduct a yearlong pilot program to educate parent and other caregivers to guard against accidental poisoning. The program distributed educational materials in English and Spanish to parent of newborns in the goodie-bags they received at discharge, at vocational resorts, public libraries and day care centers

Successful Programs

Falls• The fall prevention task force in San Mateo county California is

a community base program sponsored by the San Mateo county health department and the Stanford university medical center to decrease and prevent falls among older adults– The program provides information about fall prevention strategies

in English, Spanish, and Chinese to San Mateo county residents older than 65

– The program offers free home visits by an occupational therapist with the focus on medication review, home safety assessment and modification, home exercise program, and balance and mobility assessment to residents older than 65

Successful Programs

Fire• Some fire departments offer free smoke

detectors and installation on request• Some fire departments also offer free smoke

detectors for the deaf or hearing impaired

Gaps in service

• Limited Programs• Smoke alarm installation & fire safety education– Only 1 local fire teaching program in the area

provided by Buckets the Clown in VA beach• General education services for injury prevention

in regards to poisoning, medication storage and safety, seatbelt safety and fall prevention

• Look to successful programs to model services to address gaps in the future

Recommendations for program improvement

Motor Vehicle• Barriers include individual resistance to the seat belt and

safety seat use laws because they limit parental or personal discretion

• Programs must use new seats instead of refurbished ones in order to make sure that seats that have been involved in a car accident are discarded

• Potential barriers to implementation of child safety seat distribution and education programs include liability, the initial expense of purchasing seats, storage of seats, and training of staff to provide education and distribute the seats.

• By increasing the number of people with safety seats, education and practice on proper use of safety seats is important to prevent potential misuse. Education and involvement may vary across programs.


Poison• Expand the availability of and promote the use of early

enrichment programs for all children from families with low levels of economic and social resources who are living in areas where exposure to lead is likely.

• When eliminating lead in properties, use trained workers and lead-safe work practices that are in compliance with federal, state, and local regulations.

• Direct parents to local, state, and federal agencies and organizations for information, particularly concerning methods to identify lead hazards and to repair them safely.


Falls• Effective fall interventions reduce fall risk factors through either exercise alone or by

combining exercise with other risk reduction approaches such as medication review and management, vision screening and correction, education, and safer living environments.

• Exercises that improve mobility, strength, and balance, and that are taught by trained, nationally certified exercise instructors or physical therapists. Exercise programs include:– Tai Chi– Individualized exercise sessions – Group exercise classes– Home exercise programs with supervision until the

older adult can exercise independently• Medication review will identify side effects or drug

interactions that may contribute to falls. The reviews should be conducted by pharmacists or healthcare providers.


Fire• Assess the area• Utilize the leadership of the fire department

– Must be well informed and involved. Those who resist change or program activities will create a barrier to the success of the program

• Utilize outside resources such as the National Fire Protection Association and the U.S. Fire Administration

• Poor socioeconomic status has been associated with both lack of smoke detectors and inoperable smoke detectors. 10 year lithium battery operated smoke detectors can be provided as part of an intervention and installation is free.

Comprehensive Research Needs to Reduce Unintentional Injury Death

• Target change in environment and social norms• Identify best formats and channels of

intervention delivery• Develop model infrastructures for interventions

that include public health agencies and community networks with a focus on emergent health issues.

• Identify barriers to widespread adoption and test methods to overcome barriers.

References• Baltimore City Fire Department. Retrieved from

http://www.baltimorecity.gov/Government/AgenciesDepartments/Fire/SafetyandPrevention/SmokeDetectors.aspx

• Binns HJ; Campbell C; Brown, M. (2007). Interpreting and managing blood lead levels of less than 10 microg/dL in children and reducing childhood exposure to lead: recommendations of the Centers for Disease Control and Prevention Advisory Committee on Childhood Lead Poisoning Prevention. Pediatrics, 120(5), e1285-e1298.

• California Poison Control system. Retrieved from www.calpoison.org

• Child passenger safety. Retrieved from http://www.vahealth.org/Injury/safetyseat/

• DMV Virginia Highway Safety Office. (n.d.). Operation air, land, and speed results. Retrieved from http://www.dmv.state.va.us/webdoc/safety/crash_data/air_land_speed.pdf

• Governors Highway Safety association. Retrieved from www.ghsa.org

• Healthy People 2020. (2012). Retrieved from http://www.healthypeople.gov/2020/default.aspx

References• Hwang, V., Duchossois, G. P., Garcia-Espana, J. F., & Durbin, D. R. (2006). Impact of a

community based fire prevention intervention on fire safety knowledge and behavior in elementary school children. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2563473/

• Insurance Institute for highway safety. Retrieved from www.iihs.org• Motor Vehicle Occupant Injury. Retrieved from

http://www.thecommunityguide.org/mvoi/motor-vehicles.pdf

• National Center for Injury Prevention and Control (U.S.). (2009). CDC injury research agenda: 2009-2018. Atlanta, Ga.: U.S. Dept. of Health and Human Services, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Retrieved from http://www.cdc.gov/ncipc.

• National Safety Council. Retrieved from www.nsc.org• Norfolk Fire Department. Retrieved from www.norfolk.gov/nfr/• Poison prevention fact sheet. (2009). Retrieved from

http://www.vahealth.org/injury/data/factsheets/Poison%20Fact%20Sheet.p df

References• Preventing falls. Retrieved from

http://www.vahealth.org/Injury/data/factsheets/fallfactsheet.pdf• Preventing falls: How to develop community-based fall prevention programs for older

adults. Retrieved from http://www.cdc.gov/homeandrecreationalsafety/images/cdc_guide-a.pdf

• Public fire education planning for urban communities: A five-step process guide to success. Retrieved from http://www.nfpa.org/assets/files/PDF/Public%20Education/Urban5StepProc ess.pdf

• Rockett, I. R. H., Regier, M. D., Kapusta, N. D., Coben, J. H., Miller, T. R., Hanzlick, R. L., et al. (2012). Leading causes of unintentional and intentional injury mortality: United States, 2000-2009. American Journal of Public Health, e1- e9. doi:10.2105.AJPH.2012.300960

• San Mateo County Fall Prevention Task Force. Retrieved from www.smcfallprevention.org

• Stewart, Hyder, A., Herbert, H., Stewart, Hyder, A., Herbert, H., & Stevens, K. (2012). Unintentional injuries: magnitude, prevention, and control. Annual Review Of Public Health, 33175-191.

References• The Pilot Newspaper of NC. Retrieved from www.thepilot.com• Traffic safety facts. (2010). Retrieved from

http://www.nrd.nhtsa.dot.gov/CATS/index.aspx• Unintentional injury deaths. Retrieved from

http://www.healthindicators.gov/Indicators/Unintentional- injury-deaths-per-100000_1074/Profile

• United states census bureau (2012). Retrieved fromhttp://www.census.gov/population/www/popclockus.html

• U.S. Department of Transportation. (2012). 2010 motor vehicle crashes: overview. Traffic safety facts, p. 1-6.

• U.S. National Highway Traffic Safety Administration. (2012). Retrieved from http://www.census.gov/compendia/statab/2012/tables/12s1103.pdf

References• Virginia Association of Driver Education and Traffic Safety. Retrieved from

www.safeteendriving.org• Virginia Department of Health: Injury in Virginia, 2000-2009. Retrieved from

http://www.vahealth.org/Injury/data/documents/2012/pdf/tenyr_report_fi nal.pdf• Virginia Department of Health. (2011). Distracted driving in Virginia, 2005-2009. • Virginia Injury Update,5(1), Retrieved from

https://www.blackboard.odu.edu/@@/ECCEAF8581F39AFE65432F9DCCCEE EA5/courses/1/201210_FALL_NURS470_12041/db/_3161132_1/Distracted Driving Report 2011.pdf

• Virginia Department of Health. Retrieved from http://www.vdh.state.va.us/• Virginia injury report. Retrieved from

http://www.vahealth.org/injury/data/reports/documents/2007/pdf/Virginia %20Poison%20Report%201999%20-%202004.pdf

• Virginia Poison Control Network. (2007). Retrieved from http://www.vdh.virginia.gov/OEMS/PoisonControl/VPCN_02-10-11.pdf

• Warner, M., Chen, L.H., Makuc, D.M., Anderson, R.N. & Minino, A.M. (2011). Drug poisoning deaths in the united states, 1980-2008. NCHS data brief, 81, 1-8.

Injury and Violence Prevention

Documents

Transcript of Injury and Violence Prevention