1. Injuries as a Community and Public Health Problem
Chapter 15
Injuries as a Community and Public Health Problem

2. Chapter Objectives (1 of 2)
After studying this chapter, you will be able to:
Describe the importance of injuries as a community and public health problem.
Explain why the terms accidents and safety have been replaced by the currently more acceptable terms unintentional injuries, injury prevention, and injury control when dealing with such occurrences.
Briefly explain the difference between intentional and unintentional injuries and provide examples of each.
List the four elements usually included in the definition of the term unintentional injury.
Summarize the epidemiology of unintentional injuries; that is, when, where, and to whom injuries occur.
List strategies for the prevention and control of unintentional injuries.
Explain how education, regulation, automatic protection, and litigation can reduce the number and seriousness of unintentional injuries.

3. Chapter Objectives (2 of 2)
Define the term intentional injuries and provide examples of behavior that results in intentional injuries.
Describe the significance of intentional injuries as a community and public health problem in the United States.
Name the victims and perpetrators of domestic violence. Discuss the types of injuries that result from domestic violence.
List some contributing factors to domestic violence and some strategies for reducing it.
Define the term youth gang and explain how they finance themselves. Explain why some young people join these gangs.
List ways communities can reduce youth gang activity.
Discuss local, state, and national resources available to communities for reducing the number and severity of international injuries resulting from violence in the community.

4. Introduction Definitions Injury Unintentional injuries

5. Cost of Injuries to Society (1 of 3)
Leading cause of death and disability in the world
Over 5 million people die from injuries each year
Fatal injuries
Disabling injuries

6. Cost of Injuries to Society (2 of 3)
Centers for Disease Control and Prevention, Injury Prevention and Control: Data & Statistics (WISQARSTM) (2015). “Fatal Injury Reports.” Available at:
Injury deaths: United
States, 2014.

7. Cost of Injuries to Society (3 of 3)
Summary Health Statistics for the U.S. Population: National Health Interview Survey, Available at
Centers for Disease Control and Prevention (2014). “Youth Risk Behavior Surveillance—United States, 2013.” Morbidity and Mortality Weekly Report, 63(SS-4) Available at
Data from: Centers for Disease Control and Prevention, Injury Prevention and Control: Data & Statistics (WISQARSTM) (2015). “Fatal Injury Reports.” Available at:
Centers for Disease Control and Prevention, National Centers for Health Statistics (2015).
Burden of injury, United States, 2014.

8. Unintentional Injuries
The cause of nearly two-thirds of all injury-related deaths in the U.S.
Injury prevention or injury control
Unsafe act and unsafe condition
Types of unintentional injuries
Poisonings
Motor vehicle crashes
Falls
Other types of unintentional injuries

9. Poisonings Leading cause of unintentional injury death in 2014
Unintentional ingestion of fatal doses of medicines and drugs
Consumption of toxic foods
Exposure to toxic substances in the workplace or elsewhere
Most occur in the home

10. Motor Vehicle Crashes
Second leading type of unintentional injury death
Majority of those killed are
Drivers
Passengers
Motorcycle riders
Pedestrians
Pedalcyclists

11. Falls Third leading cause of unintentional injury death
Leading cause of injury-related medically consulted injury
Most occur in the home
Disproportionately affect elders

12. Epidemiology of Unintentional Injuries
Account for large number of early deaths in U.S.
Incapacitation significant problem
High economic impact

13. Person (1 of 2) Age Gender Minority status
Leading cause of death in children and ages 1-44
Gender
Males more likely to be involved in fatal unintentional injuries
Minority status

14. Rates of medically consulted injuries by age and sex, 2013.
Person (2 of 2)
Centers for Disease Control and Prevention, Injury Prevention and Control: Data & Statistics (WISQARSTM) (2015). “Nonfatal Injury Reports.” Available at:
Rates of medically consulted injuries by age and sex, 2013.

15. Place (1 of 2) Home Highway Recreation and sports venues
More occur in the home than anyplace else
Highway
Recreation and sports venues
School, child care center, or preschool
Workplace

16. Unintentional injury deaths by class,
Place (2 of 2)
National Safety Council (2015). Injury Facts, 2015 Edition. Itasca, IL. Author.
Unintentional injury deaths by class,
United States, 2014.

17. Time Seasonal variations in various causes of unintentional injuries
Day of week
Time of day

18. Alcohol and Other Drugs as Risk Factors (1 of 2)
Alcohol may be most important factor contributing to injuries
Involved in high number of motor vehicle crashes
Related to speeding, seat belt use, and other behaviors

19. Alcohol and Other Drugs as Risk Factors (2 of 2)
U.S. Department of Transportation, National Highway Traffic Safety Administration (2015). Traffic Safety Facts 2013: A Compilation of Motor Vehicle Crash Data from the Fatality Analysis Reporting System and the General Estimates System (DOT HS ). Washington, DC: U.S. DOT.
Alcohol impairment for vehicle operators killed in single vehicle crashes

20. Prevention through Epidemiology (1 of 2)
Early contributors for injury prevention and control
John Gordon
William Haddon, Jr.

21. Prevention through Epidemiology (2 of 2)
Model for unintentional injuries - triangle
Environment, host, and energy-producing agent

22. Prevention and Control Tactics Based on the Model
Prevent accumulation of energy producing agent
Prevent inappropriate release of excess energy
Place barrier between host and agent
Separate host from potentially dangerous sources of energy
Other tactics

23. Community Approaches to Prevention of Unintentional Injuries
Education – process of changing people’s health-directed behavior
Regulation – enacting and enforcing laws to control conduct
Automatic protection – modifying products or environments to reduce risk
Litigation – seeking justice for injury through courts

24. Intentional Injuries
Outcome of self-directed or interpersonal violence
Staggering community health problem in the U.S.

25. Types of Intentional Injuries
Assaults, rapes, suicides, homicides
Can be perpetrated against family members, community members, or complete strangers
Costly due to loss of life and productivity, and economic cost to community

26. Epidemiology of Intentional Injuries
Interpersonal violence disproportionately affects those frustrated, hopeless, jobless, living in poverty, with low self-esteem
More acts committed by males
Firearms increasingly involved
Alcohol and drug use contributes
Perpetrators more likely to have been abused or neglected as children or exposed to violence

27. Homicide, Assault, Rape, and Property Crimes
Males, blacks, and young people experience highest rates of violent victimization
Less than half of all violent crimes committed are reported to police
2014: only 34% of rapes and sexual assaults reported to police

28. Suicide and Attempted Suicide
Suicide rate for men four times that for women
Suicide rate for young people increased between to highest rate in 10+ years
Suicide rates for elder men are highest for any population subgroup

29. Firearm Injuries and Injury Deaths
Intentional and unintentional acts, firearms third leading cause of injury death
Highest risk for homicide and suicide involving firearms are teenage boys and young men
Guns on college campuses
Absence of detailed federally supported reporting system

30. Violence in Our Society and Resources for Prevention
Individuals and violence
Family violence and abuse
Child maltreatment
Child abuse
Child neglect
Prevention of child maltreatment
Elder maltreatment and prevention
Intimate partner violence
Prevention of intimate partner violence

31. Violence in Schools
Victimization rates have remained steady in recent years
Fighting and weapon carrying
Zero tolerance policies
Bullying and being bullied
Safe Schools/Healthy Students Initiative
Youth violence after school

32. Violence in Our Communities
Youth gang violence
Costs to the community
Community response
State response
Federal response

33. Discussion Questions
What levels of prevention can be most effective in reducing violence in communities?
How can unintentional injury rates continue to decline in the coming decades?