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Injuries as a Public Health Problem Intermediate Injury Prevention Course Billings, Montana August 2011.

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Presentation on theme: "Injuries as a Public Health Problem Intermediate Injury Prevention Course Billings, Montana August 2011."— Presentation transcript:

1 Injuries as a Public Health Problem Intermediate Injury Prevention Course Billings, Montana August 2011

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3 Session Objectives Severity of injuries facing AI/AN communities Costs of injury / cost benefits of prevention Community benefits of injury prevention Public Health Approach to preventing injuries Value of data in preventing injury

4 Why Injury Prevention? AI/AN injury rate higher than US all races AI/ANs ages 1-44 are greatly affected Injuries are very costly to treat

5 Injury Types Unintentional Injury Unintentional Injury –falls, motor vehicle crashes, drowning, fire/burn, bicycle, off-road vehicles, Intentional Injury Intentional Injury –Suicide or attempt –homicide & assault –child/elder abuse

6 What Injuries Are Not Injuries are not accidents! Injuries are not accidents! They do not happen by chance. They do not happen by chance. They are not random acts. They are not random acts.

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9 Swift River Rescue

10 An ounce of prevention is worth a pound of cure.

11 and All U.S , United States All Injury Deaths and Rates per 100,000 Am Indian/AK Native and All U.S. CDC WISQARS,

12 Injury Severity Fatal Injury Fatal Injury –Injury that results in death of the victim Severe Injury Severe Injury –Injury that results in a hospital stay Ambulatory Injury Ambulatory Injury –Less severe injuries that do not require a hospital visit

13 Fatal Injury Rates Per IHS Area WA Portland Billings Aberdeen Bemidji ORID MT WY ND SD NE MN IA WI MI IN ME NY PA California 70.9 CA NV UT AZ AK CO NM KS OK TX LA MS AL FL SC NC TN Tucson Navajo Albuquerque Oklahoma City 87.8 Nashville 81.5 Phoenix Alaska Source: Indian Health Focus - Injuries US DHHS Data includes all injury types Rates are per 100,000 service population US All Races Rate: 52.2

14 Leading Causes of Injury Death All ages AI/AN – (2007) Billings Area CauseRateUS Rate Suicide Poisoning MVC Homicide Firearms Fall Fire/Burn Rates are per 100,000 service population CDC WISQARS

15 What are the costs of injury? Physical Losses Physical Losses Financial Financial Emotional Emotional Treatment Treatment

16 Financial burden of injury

17 Buzz Group: What injuries affect YOUR community? Do these data agree with the injury problem in your community/region? Do these data agree with the injury problem in your community/region? What are leading causes of severe injury in your community? What are leading causes of severe injury in your community? Why might these lists look different? Why might these lists look different?

18 National Injury Costs $224 Billion Annually Cost involved Cost involved –Medical care, rehabilitation, lost wages / productivity Who pays Who pays –Private share 72% (or about $161 Billion) –Public share 28% (or about $63 Billion) Federal share Federal share –$12.6 Billion in medical costs –$18.4 Billion in disability/death costs Source: CDC, National Center for Injury Prevention and Control

19 Average Cost of Hospitalizations California, Source: California Department of Health Services

20 AI/AN Injury Costs IHS Injury Treatment Costs IHS Injury Treatment Costs –Inpatient »$1507/day (Medicaid reimbursement rate for 1 day at an IHS facility) –Contract Health »$11,305/inpatient case »$570/outpatient case One Alaska Corporation (TCC) spent $4.15 million for injury hospitalizations from One Alaska Corporation (TCC) spent $4.15 million for injury hospitalizations from Sources - (1) Indian Health Focus-Injuries (2) Chandler B, Berger L: Financial Burden of Injury-Related Hospitalizations to an Alaska Native Health System

21 Cost of Injury Hospitalizations TCC Source - Chandler B, Berger L: Financial Burden of Injury-Related Hospitalizations to an Alaska Native Health System

22 Conceptual Shifts in Injury Prevention Single-cause, Behavioral approach Multiple-causes, Environmental approach Multiple-causes, Multiple approaches Blaming the victim Focus on engineering out injuries Balanced approach

23 Public Health Approach Define the Problem Surveillance Identify Risk Factors Who, What? Source: National Center for Injury Prevention and Control, CDC Find what Prevents the Problem What Works? Implement & Evaluate Programs Prevention

24 A Public Health Approach: Starts with defining the problem and moves toward identifying risk and protective factors. It also includes developing, implementing, and evaluating injury prevention interventions

25 Financial benefits of injury prevention

26 Interventions that $ave Money Primary seat belt laws/Child Car Seats Primary seat belt laws/Child Car Seats Streetlights and guardrails Streetlights and guardrails Bike helmets Bike helmets

27 Interventions that $ave Money DUI Laws DUI Laws Personal Floatation Devices Personal Floatation Devices Smoke detectors Smoke detectors Gun locks Gun locks

28 Safety equipment saves more than lives... Every bike helmet (for kids 4 – 15) saves $395 in treatment costs Every bike helmet (for kids 4 – 15) saves $395 in treatment costs Every child seat saves $1,360 Every child seat saves $1,360 Every smoke detector saves $900 Every smoke detector saves $900 References: National Public Services Research Institute / National SAFE KIDS Campaign

29 Injury Prevention: Potential for Cost Savings Victim Treatment costs resulting from each Motor Vehicle Crash: NOT wearing a seat belt $2,395 Wearing a seat belt $470 Source - Phipps L: Cost Comparison of Medical Treatment for Restrained vs. Unrestrained Motor vehicle crash victims at a northeast Oklahoma IHS hospital (IHS Injury Prevention Fellowship)

30 Injury Prevention Cost Savings Projects in Indian Country Navajo Nation – occupant restraint usage Navajo Nation – occupant restraint usage Whiteriver, AZ – pedestrian crash reduction Whiteriver, AZ – pedestrian crash reduction White Mountain Apache – livestock control White Mountain Apache – livestock control Y-K Delta, AK – drowning prevention Y-K Delta, AK – drowning prevention

31 Community Cultures/Values Extended families Extended families Knowledge of community infrastructure Knowledge of community infrastructure Local, non-appointed influential people Local, non-appointed influential people Traditional values and teachings Traditional values and teachings

32 Community benefits from injury prevention cost savings Elective medical services Elective medical services –more non-emergent treatments (surgeries, therapies, preventive services, other programs) Resources for additional community services Resources for additional community services –housing authorities –transportation programs

33 Using Data to Define Injury Problems Data identifies patterns and trends Data identifies patterns and trends Observation data documents behaviors Observation data documents behaviors Interview and Focus Group data can be used to identify knowledge, perceptions, and attitudes Interview and Focus Group data can be used to identify knowledge, perceptions, and attitudes

34 Collecting and Analyzing Data to Determine Injury Risk Factors Population at risk Population at risk –age, gender, specific group Location(s) of events Location(s) of events –inside home, road location, at work Environmental factors Environmental factors –lighting, road conditions, weather Other factors Other factors –alcohol use, use of safety devices

35 Using Data to Select Preventive Measures E Modify the Environment E Educate the public E Enact and Enforce safety legislation

36 Using Data to Evaluate Programs Help develop intervention materials Analyze effectiveness of methods used Use evaluation to improve prevention measures

37 Summary Severity of injuries facing AI/AN communities Costs of injury / cost benefits of prevention Community benefits of injury prevention Public Health Approach to preventing injuries Value of data in preventing injury


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