The British Columbia Casebook for Injury Prevention The BC Casebook for Injury Prevention is a call to action, making the case for injury prevention in British Columbia. Everyone has a role in prevention, working collaboratively to implement evidence-based solutions to save lives and prevent disabilities. When sustained resources are available and collaborative efforts that use multiple strategies are applied, injuries can be prevented. The British Columbia Casebook for Injury Prevention

What injuries are we talking about? Injuries can be intentional meaning self-inflicted or inflicted by another person, or unintentional, what we have traditionally labelled “accidents”. Injury can be defined as damage to the body resulting from the transfer of physical energy (mechanical, thermal, electrical, radiant, chemical) or from the absence of essential energies (e.g., heat) (Ref: Morrongiello, B., 2003) This presentation makes the case for injury prevention in BC and the statistics are compelling…

Why focus on injuries? Every day, approx. 1,300 people in BC are injured. Of these, 5 die – each and every day. In addition, 23 people per day suffer a permanent disability in BC. More than 400,000 residents of BC are injured each year, with over 2,000 dying from their injuries. More than 8,500 are left with a permanent disability, affecting them for the rest of their lives, and placing a continuing burden on family, friends and the health care system after an injury. Most are young, and in their most productive years. Yet as many as 90% of these injuries are both predictable and preventable.

Injury is robbing our communities of young people. Injury is the 4th leading cause of death for all ages, but the leading cause of death for ages 1-44 years. In one year, injuries accounted for 24,807 preventable years of life lost among British Columbians ages 1-44 years. From birth to retirement, injuries are the leading cause of Preventable Years of Life Lost (PrYLL). PrYLL estimates the average number of years a person would have lived if he or she had not died due to a preventable cause of death. When we compare preventable causes of death, deaths due to injury represent the leading causes of PrYLL; well ahead of other preventable causes like heart disease and cancer, where people more typically die at older ages. In one year, injuries accounted for nearly 25,000 preventable years of life lost for ages 1-44 years. In comparison, preventable cancers accounted for nearly 4,000 preventable years of life lost.

Injury costs British Columbia $3.7 billion per year. $3.7 billion is the equivalent of $422, 479 per hour 24 hours a day 7 days a week each year The majority of injury health care costs per capita are spent on older adults and youth (pie charts in Casebook, page 17). When the health care costs are broken down by cause of injury among older adults, most of the health care costs are spent on fall-related injuries. When compared to other age groups, ages 15-24 years have the highest per capita health care costs associated with transport injuries (e.g. Motor vehicle or ATV crashes, hit while cycling, etc.), suicide/self-harm, injuries due to violence and unintentional poisoning. When considering Preventable Years of Life Lost, along with cost, it is clear that injury prevention policies, environmental modification, education and programming need to target ages 15-24 years.

Investment in injury prevention pays big dividends. Investing in prevention provides an opportunity for positive change – saving lives, reducing disabilities and saving health care resources. There is clear evidence that injury interventions can reduce the number of people requiring health care services – such as addressing falls, helmet use and traffic speed.   Upstream investment in injury prevention translates to injury costs avoided and financial resources available for reallocation to other important health care areas. While it is important to recognize that resources will be required to embark upon injury prevention interventions, the investment if relatively modest when compared to other health interventions such as surgery, hospital care and rehabilitation – and the overall cost-savings to the health care system are significant. For example, Each dollar invested in a child resistant cigarette lighter saves society $80 Each dollar spent on a booster seat saves society $71 Each dollar spent on a bicycle helmet saves society $45 (more examples in Casebook, page 19)

We need to understand local data in order to determine local prevention needs and priorities. It is critical to develop an understanding of the groups that are most affected by specific causes of injury in order to inform where to focus injury prevention efforts. The challenge in approaching injury prevention is to understand a local context in order to determine local needs and priorities. Health authorities need to focus on the causes of injury specific to their regions. Understanding the specifics of the burden of injury in their region, together with the application of proven practices, will aid in prevention and the reduction of the injury burden.

Decision makers have the challenge of addressing multiple priorities. Injury is not an isolated problem. Injury is associated with many of the same determinants that lead to chronic diseases, communicable diseases, mental illness, substance abuse, and is part of a complex puzzle within public health. Injury prevention efforts complement and benefit from work on other public health issues.   It needs to be considered as part of the overall solution to improving the health of individuals, families and communities. Supporting injury priorities will have a positive impact on public health and healthy family priorities. Investments in injury prevention support healthy choices and behaviours across the lifespan and across a host of public health issues.

Identified injury prevention priorities for British Columbia are represented in the case studies. Injury prevention stakeholders, especially within the health authorities, are encouraged to review all of the case studies included in the Casebook. These are great examples of what is working in BC to prevent injury. Case Study 1: Shaken Baby Syndrome Case Study 2: Injury Prevention Messaging Case Study 3: Concussion Prevention Case Study 4: Injury Surveillance & Prevention Case Study 5: Seniors’ Falls Prevention Case Study 6: Road Safety Case Study 7: Alcohol-Related Injuries Case Study 8: Suicide Prevention Case Study 9: Social Marketing for Injury Prevention

The good news is that injury rates in general are decreasing in British Columbia. It is time to work together to implement evidence-based solutions that prevent injuries so that British Columbians can live long lives to the fullest.   Sustained and collaborative effort has resulted in a steady decrease in the number of deaths on BC roads from 2000-2013. This reduction is supported by continued resource and collaboration directed towards motor vehicle crashes.   During the same period, deaths due to injuries in the home and community have increased, resulting in more deaths, hospitalizations and permanent disabilities. Chapter 10 in the Casebook includes a list of 10 things that you can do to take action on the important issue of injury prevention. Injury prevention organizations such as the BC Injury Research and Prevention Unit and Parachute Canada are available to provide more information and guidance for injury prevention action in your jurisdiction.

The British Columbia Casebook for Injury Prevention Injuries can be prevented. The BC Casebook for Injury Prevention is available at www.injuryresearch.bc.ca . Thank you. The British Columbia Casebook for Injury Prevention