1. The Impact of Injuries on American Indians in the Dakotas Aberdeen Area 2008 John Weaver

2. Injuries in the Dakotas Unintentional injuries –are the leading cause of death for American Indians/Alaska Natives (AI/AN) in the age group 1-44 (CDC1999-2005) –are the third leading cause of death in all age groups for the years 1999-2005 (CDC) –rate was reported as 3.4 times higher than all U.S.( IHS Regional Differences in Indian Heath 1998/1999)

3. Injuries in the Dakotas There is a need to determine injury causes –Target injury groups –Develop interventions –Evaluate if programs are successful

4. Injuries in the Dakotas The Severe Injury Surveillance System Seven Sites collected two years of data

5. Injury Causes by Age Groups 2005-2006 CauseMVCFallFire/BurnDrowningSuicideAssaultOther Age Group 0-416116400844 5-915162201239 10-144415110223376 15-2420523850158322152 25-34111154805624582 35-4487201103716864 45-545317731167841 55-64251341041618 65 +11162002612

6. Leading Causes of Injury and Death by Severity Outpatient Inpatient Mortality 2005/2006 2005/2006 2001/2006 1. Falls (1100) Falls (252) Motor Vehicle (256) 2.Assaults (543) Motor Vehicle (246) Other (109) 3. Other (355) Suicide (231) Suicide (72) 4. Motor Vehicle (236) Assaults (217) Assaults (47)

8. Injuries in the Dakotas A standardized seat belt use survey was developed Staff trained and Data collected

9. Results A total of 20,927 seat belt use observations were conducted (n=15,196 drivers and n=5,731 passengers) The overall all passengers seat belt use rate for individual tribes ranged from 8% to 42%. Combined seat belt use data for the 10 reservations, the overall seat belt use rate was 21% for drivers, 16% for passengers, and 20% for all passengers (combined drivers and passengers)

10. Injuries in the Dakotas The seat belt use rate for Americans Indians in the Northern Plains is low 2007 observed seat belt use rate in Aberdeen Area is 20% 2007 National use rate was 82% 2007 North Dakota use rate was 82% 2007 South Dakota use rate was 73%

11. What Works The combination of enforcement and public information campaigns appears to be the key to achieving meaningful, lasting increases in restraint usage. Public education effort alone, without an enforcement component, are generally not successful. Insurance Institute for Highway Safety 2001

12. Evidence-Based Effective Strategies  Why Are Effective Strategies Important? Source: AJPM, Systematic Reviews of Strategies to Prevent Motor Vehicle Injuries, 1998.  Because Resources Are Always Limited, Efforts Should be Spent on Injury Prevention Programs That are Proven Effective.

13. Injuries in the Dakotas National Highway Traffic Safety Administration (NHTSA) Survey of Native American Tribal Reservations found –Reservations with primary safety belt laws have 87% of the vehicle occupants belted –Reservations with secondary belt laws averaged 53% seat belt use –Reservations with no seat belt laws of any kind, the usage rate was 26%.

14. Injuries in the Dakotas Tribal policy and procedures can have a direct impact on levels of safety belt use Tribal efforts can be most effective in establishing and improving safety belt usage levels (NHTSA DOT HS809 921 Oct. 2005) Evidence-based research shows that passage of seat belt use laws, coupled with education and enforcement efforts, are effective tools to increase seat belt use Use of seat belts can reduce the risk of death in a motor vehicle crash by 45% to 60%, and can reduce moderate to critical injury 50% to 65%

15. Injuries in the Dakotas An example of Tribal Government applying evidence-based strategies –Sisseton-Wahpeton Oyate of the Lake Traverse Reservation’s Injury Prevention Program Court ordered monthly victim impact panels Seat belt use check points Increasing traffic safety citations Occupant seat belt surveys Numerous newspaper articles

16. Injuries in the Dakotas Project efforts led to an 80% increase among drivers (25% to 45%) and an over 250% increase among passengers (9% to 34%).

17. Thank You Questions

19. Effectiveness of Child Restraints 71% effective in reducing infant deaths 54% effective in reducing toddler deaths 69% effective in reducing hospitalization Children = 37% less likely to be fatally injured riding in the rear seat

20. Effectiveness of Lap/Shoulder Belts 40% to 50% effective in reducing deaths 45% to 55% effective in reducing injuries