1. Seat Belts... A Matter of Dollars and Sense... Ginger Floerchinger-Franks, M.S., Dr.P.H. Idaho Department of Health & Welfare Bureau of Health Promotion Mary Hunter Idaho Transportation Department Office of Highway Safety

2. Topics To Be Covered Injury in Idaho versus U.S. TBI estimates Injury Prevention Strategies – Overview The Seat Belt Connection Past Motor Vehicle Injury Prevention Efforts Costs

3. YPLL- 65: U.S. & Idaho, 2000

4. 10 Leading Causes of Death – U.S. 2000 Age Groups Rank <11-45-910-1415-2425-3435-4445-5455-6465+All Ages 1 Congenital Anomalies 5,743 Unintentiona l Injury 1,826 Unintentiona l Injury 1,391 Unintentiona l Injury 1,588 Unintentiona l Injury 14,113 Unintentiona l Injury 11,769 Malignant Neoplasms 16,520 Malignant Neoplasms 48,034 Malignant Neoplasms 89,005 Heart Disease 593,707 Heart Disease 710,760 2 Short Gestation 4,397 Congenital Anomalies 495 Malignant Neoplasms 489 Malignant Neoplasms 525 Homicide 4,939 Suicide 4,792 Unintentiona l Injury 15,413 Heart Disease 35,480 Heart Disease 63,399 Malignant Neoplasms 392,366 Malignant Neoplasms 553,091 3 SIDS 2,523 Malignant Neoplasms 420 Congenital Anomalies 198 Suicide 300 Suicide 3,994 Homicide 4,164 Heart Disease 13,181 Unintentiona l Injury 12,278 Chronic Low. Respiratory Disease 10,739 Cerebro- vascular 148,045 Cerebro- vascular 167,661 4 Maternal Pregnancy Comp. 1,404 Homicide 356 Homicide 140 Homicide 231 Malignant Neoplasms 1,713 Malignant Neoplasms 3,916 Suicide 6,562 Liver Disease 6,654 Cerebro- vascular 9,956 Chronic Low. Respiratory Disease 106,375 Chronic Low. Respiratory Disease 122,009 5 Placenta Cord Membranes 1,062 Heart Disease 181 Heart Disease 106 Congenital Anomalies 201 Heart Disease 1,031 Heart Disease 2,958 HIV 5,919 Cerebro- vascular 6,011 Diabetes Mellitus 9,186 Influenza & Pneumonia 58,557 Unintentional Injury 97,900 6 Respiratory Distress 999 Influenza & Pneumonia 103 Benign Neoplasms 62 Heart Disease 165 Congenital Anomalies 441 HIV 2,437 Liver Disease 3,371 Suicide 5,437 Unintentiona l Injury 7,505 Diabetes Mellitus 52,414 Diabetes Mellitus 69,301 7 Unintentiona l Injury 881 Septicemia 99 Chronic Low. Respiratory Disease 48 Chronic Low. Respiratory Disease 91 Cerebro- vascular 199 Diabetes Mellitus 623 Homicide 3,219 Diabetes Mellitus 4,954 Liver Disease 5,774 Alzheimer's Disease 48,993 Influenza & Pneumonia 65,313 8 Bacterial Sepsis 768 Perinatal Period 79 Influenza & Pneumonia 47 Cerebro- vascular 51 Chronic Low. Respiratory Disease 190 Cerebro- vascular 602 Cerebro- vascular 2,599 HIV 4,142 Nephritis 3,100 Nephritis 31,225 Alzheimer's Disease 49,558 9 Circulatory System Disease 663 Benign Neoplasms 53 Septicemia 38 Influenza & Pneumonia 40 Influenza & Pneumonia 189 Congenital Anomalies 477 Diabetes Mellitus 1,926 Chronic Low. Respiratory Disease 3,251 Suicide 2,945 Unintentiona l Injury 31,051 Nephritis 37,251 10 Intrauterine Hypoxia 630 Chronic Low. Respiratory Disease 51 Two Tied 25 Benign Neoplasms 37 HIV 179 Liver Disease 415 Influenza & Pneumonia 1,068 Viral Hepatitis 1,894 Septicemia 2,899 Septicemia 24,786 Septicemia 31,224

5. 10 Leading Causes of Death – Idaho 2000 Age Groups Rank <11-45-910-1415-2425-3435-4445-5455-6465+All Ages 1 Congenital Anomalies 48 Unintentiona l Injury 7 Unintentiona l Injury 14 Unintentiona l Injury 12 Unintentiona l Injury 74 Unintentiona l Injury 63 Unintentiona l Injury 69 Malignant Neoplasms 176 Malignant Neoplasms 322 Heart Disease 2,129 Heart Disease 2,519 2 Short Gestation 16 Congenital Anomalies 3 Heart Disease 3 Suicide 4 Suicide 31 Suicide 28 Malignant Neoplasms 65 Heart Disease 105 Heart Disease 224 Malignant Neoplasms 1,534 Malignant Neoplasms 2,128 3 SIDS 12 Malignant Neoplasms 1 Congenital Anomalies 2 Malignant Neoplasms 2 Malignant Neoplasms 8 Malignant Neoplasms 17 Heart Disease 48 Unintentiona l Injury 72 Chronic Low. Respiratory Disease 52 Cerebro- vascular 660 Cerebro- vascular 720 4 Maternal Pregnancy Comp. 9 Perinatal Period 1 Influenza & Pneumonia 1 Homicide 1 Heart Disease 3 Homicide 7 Suicide 28 Liver Disease 27 Unintentiona l Injury 49 Chronic Low. Respiratory Disease 501 Chronic Low. Respiratory Disease 569 5 Placenta Cord Membranes 9 Malignant Neoplasms 1 Diabetes Mellitus 2 Diabetes Mellitus 5 Liver Disease 12 Suicide 25 Diabetes Mellitus 43 Influenza & Pneumonia 261 Unintentional Injury 518 6 Intrauterine Hypoxia 7 Homicide 2 Congenital Anomalies 4 Cerebro- vascular 10 Cerebro- vascular 17 Cerebro- vascular 31 Alzheimer's Disease 258 Diabetes Mellitus 304 7 Neonatal Hemorrhage 7 Influenza & Pneumonia 2 Heart Disease 4 Homicide 10 Diabetes Mellitus 13 Liver Disease 26 Diabetes Mellitus 232 Influenza & Pneumonia 288 8 Unintentiona l Injury 5 Chronic Low. Respiratory Disease 1 HIV 3 Diabetes Mellitus 9 Chronic Low. Respiratory Disease 12 Suicide 13 Unintentio nal Injury 153 Alzheimer's Disease 262 9 Circulatory System Disease 4 Complicated Pregnancy 1 Influenza & Pneumonia 3 Congenital Anomalies 4 Viral Hepatitis 9 Influenza & Pneumonia 12 Parkinson's Disease 84 Suicide 167 10 Respiratory Distress 4 Two Tied 2 HIV 4 Influenza & Pneumonia 7 Nephritis 10 Nephritis 81 Liver Disease 109

6. TBI Versus All Injury Deaths U.S. – Each Year TBI ~33% of all injury deaths Idaho 1999 – 2001 TBI ~45% of all injury deaths

7. TBI Annual Estimates – U.S. 1.5 million new TBI annually 50,000 fatalities >230,000 hospitalizations 80,000 long-term disabilities 5.3 million living with a TBI disability

8. TBI Annual Estimates – Idaho Based on U.S. estimates 7,000 new TBI 235 deaths >1080 hospitalizations 375 long term disabilities ~24,900 living with a TBI disability

9. Changing Patterns Of TBI Fatalities: U.S. Overall: Rates are decreasing. Firearms-related: Increased to 1994. Decreased since 1995. Fall-related: Rates are increasing. Motor vehicle-related: Decreased to 1994.

10. TBI Deaths United States 1989-1998 Firearm-Related: 40% Ages 20 – 74 Motor Vehicle-Related: 34% Ages 0-19 Fall-Related: 10% Ages >75

11. Head Injury Deaths Idaho 1999 - 2001 Average: 320 per year Motor Vehicle-Related: 50% Firearm-Related: 31% Fall-Related: 14%

12. Motor Vehicle Collisions - Idaho More than 5 Idahoans are either killed or seriously injured each day. Leading cause of death for ages 5 – 34. 83% of MVC deaths are aged > 18 years. 60% of MVC fatalities involved a head injury.

13. Motor Vehicle Collision Injuries & Fatalities 1,146 Fatalities 8,891 Serious Injuries 26,375 Visible Injuries Idaho 1997 - 2001

14. INJURIES ARE NOT random accidents. ARE predictable. ARE preventable.

15. Injury Prevention: Public Health Perspective Surveillance Risk Factor Identification Program Development & Implementation Program Evaluation

16. Motor Vehicle Injury Prevention: Transportation Perspective Engineering Enforcement Education Emergency Medical Services

17. Haddon –Injury Prevention Prevent the creation of the hazard. Prevent the release or distribution of the hazard. Modify the hazard. Increase resistance to the hazard. Counter damage done by the hazard. Stabilize, repair, rehabilitate damage.

18. Haddon Matrix FACTORS PHASES HUMANAGENT OR VEHICLE PHYSICAL ENVIRONMENT SOCIOCULTURAL ENVIRONMENT PRE-EVENT EVENT POST-EVENT

19. Haddon Matrix - MVC FACTORS PHASES HUMANAGENT OR VEHICLE PHYSICAL ENVIRONMENT SOCIOCULTURAL ENVIRONMENT PRE-EVENT EVENT POST-EVENT Alcohol Use Driver’s Vision Brakes/Tires Ease of Control Road Visibility Signs/Signals Alcohol Attitudes Driving Experience Use of Safety Restraints Vehicle Size Vehicle Speed Guard Rails Recovery Areas Speed Limits Type of Safety Restraint Laws Age Physical Condition Fuel System Integrity Distance and Quality of EMS Support for Trauma Care Systems