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Injury and Violence Prevention The Road Ahead: Getting from Here to There. Healthy Carolinians- 2020 Vision Sept 30 th , 2010. From a public health perspective what we have learned to date:. Injuries & Violence are NOT: “random acts of nature” “accidental” “destiny” “chance” “bad luck”
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Injury and Violence Prevention The Road Ahead:Getting from Here to There Healthy Carolinians- 2020 Vision Sept 30th, 2010
From a public health perspective what we have learned to date: Injuries & Violence are NOT: • “random acts of nature” • “accidental” • “destiny” • “chance” • “bad luck” • “unavoidable” Injuries & Violence ARE: • Predictable • Preventable • Have known risk factors • Opportunities for prevention
Leading Causes of Chronic Disease and Injury Deathand Years of Life Lost: N.C., 2009 6,275 Deaths 869,614 ED Visits ???,??? Outpatient Visits ?,???,??? Medically Unattended Injury (home, work, school) * Based on deaths that occurred prior to age 65 Source: N.C. State Center for Health Statistics, 2009
Deaths from Injury and Violence are Only the Tip of the Iceberg The vast majority of injuries in North Carolina go unreported. Despite N.C.’s excellent reporting systems, the total burden of injury to the state is unknown. 6,275* Deaths 159,645* Hospitalizations 869,435* ED Visits ???,??? EMS ???,??? Outpatient Visits ?,???,??? Medically Unattended Injury (home, work, school) * 2008 death file, hospitalization discharge and NC DETECT (Emergency Department visits)
Unintentional Injury Defined • Occurs in a relatively short period of time. • Harmful outcome was not sought. Unintentional injuries account for more than 2/3 of all injury deaths
Intentional Injury Defined • The active, deliberate use of force over another person or against one's self • Intentional injuries account for less than 1/3 of all injury deaths
Leading Causes of Injury Deaths (by Number of Deaths,All Ages, North Carolina Residents: 2009) Motor Vehicle Crashes Suicides Unintentional Poisoning Unintentional Falls Homicides Unintentional, Other & Unspecified * Unintentional Suffocation Total Deaths = 6,074 Unintentional Fire/Burn * Unintentional Other and Unintentional Unspecified are two separate categories. Other comprises several smaller defined causes of death, while Unspecified refers to unintentional deaths that were not categorized due to coding challenges. Source: NC State Center for Health Statistics, Death file 2009; Analysis by Injury Epidemiology and Surveillance Unit
Top 6 Leading Causes of Death (All Races, Both Sexes) by Age Groups, North Carolina: 2008 Source: NC State Center for Health Statistics, Death file 2008; Analysis by Injury Epidemiology and Surveillance Unit
Percent Change in Rates Between 1999 and 2009 Leading Causes of Injury Deaths: N.C. 1999 to 2009* *Provisional data. Source: N.C. State Center for Health Statistics, Vital Statistics-Deaths, 1999-2009 Analysis by Injury Epidemiology and Surveillance Unit
An ‘average’ injury day in NC • 2,383 ED visits • ??? unattended • 17 deaths • 423 hospitalizations
A Comparison of the Rates of MVT-Related Deaths Between Male and Females: N.C., 2009 (N=1,342 Deaths) Males have higher rates of death due to MVT-related injuries than females for all age groups. Source: N.C. State Center for Health Statistics, Vital Statistics-Deaths, 2009 Analysis by Injury Epidemiology and Surveillance Unit
A Comparison of the Rates of MVT-Related Deaths by Age: N.C., 2002 & 2009 In December, 2002, N.C. enacted a graduated driver’s license program. For a sixteen year-old, the rate decreased by 40% since 2002. *<20 deaths; rates may be statistically unreliable. Source: N.C. State Center for Health Statistics, Vital Statistics-Deaths, 2002, 2009 Analysis by Injury Epidemiology and Surveillance Unit
Reportable Crashes: N.C., 2008 N = 214,358 Reportable Crashes Source: UNC Highway Safety Research Center, N.C. Crash Data, 2008 Analysis by Injury Epidemiology and Surveillance Unit
Alcohol Involvement in Reportable Crashes: N.C., 2008 (N = 214,358 Crashes) Source: UNC Highway Safety Research Center, N.C. Crash Data, 2008 Analysis by Injury Epidemiology and Surveillance Unit
Rate of Deaths due to Unintentional Falls Since 2000: N.C., 2000-2009 Source: N.C. State Center for Health Statistics, Vital Statistics-Deaths, 2000-2009 Analysis by Injury Epidemiology and Surveillance Unit
Rate of Deaths due to Unintentional Falls by Age: N.C., 2009 Source: N.C. State Center for Health Statistics, Vital Statistics-Deaths, 2009 Analysis by Injury Epidemiology and Surveillance Unit
Rates Deaths, Hospitalizations, and Emergency Department (ED) Visits Due to Unintentional Falls by Age: N.C., 2009 Source: N.C. State Center for Health Statistics, Vital Statistics-Deaths, 2008; Vital Statistics-Hospital Discharge, 2008 NC DETECT-ED, 2008 Analysis by Injury Epidemiology and Surveillance Unit
Outcome of Patients Hospitalized due to an Unintentional Fall, N.C., 2008 Source: N.C. State Center for Health Statistics-Vital Statistics-Hospital Discharge, 2008 Analysis by Injury Epidemiology and Surveillance Unit
Poisoning Deaths: N.C., 1999-2008 • In 1999, the number of unintentional poisoning deaths was 279; in 2008, the number of deaths was 1,016. Source: CDCWISQARS-2006 Analysis by the Injury Epidemiology and Surveillance Unit
Percent of Deaths Due to Violence by Manner/Intent: North Carolina Violent Death Reporting System, 2004-2009* Legal Intervention: 1% Undetermined Intent: 3% Unintentional Firearm: 1% Homicide: 35% Suicide: 61% * 2008 and 2009 data are provisional
Percent of Deaths by Method of Fatal Injury: North Carolina Violent Death Reporting System, 2004-2008* Homicide Suicide * 2008 data are provisional
From Data to Action Living lives to their full potential
Recent NC IOM Task Forces • Prevention Task Force (2010) • Adolescent Health Task Force (2009) • Substance Abuse Task Force (2009) • Child Abuse Prevention (2005) • Healthy NC 2020 (2010)
You've got to be very careful if you don't know where you are going, because you might not get there. Yogi Berra
NC Healthy People 2020 • Injury & Violence Objectives • Homicide • Suicide • Unt. Poisoning* • Unt. Falls • DWI/impaired driving • Occupational injuries *priority topic
North Carolina Strategic Plan for Prevention Injury and Violence
North Carolina’s first Strategic Plan for Preventing Injuries and Violence • Reduce the rate of morbidity and mortality from injury and violence by 15%.
More than 60 agencies and individuals worked over the course of a year to develop. • Focuses efforts on leading causes of death and morbidity.
Statewide Objectives • Unt. Motor Vehicle • Unt. Poisoning • Unt. Falls • Homicide • Suicide
Themes for this year • From data to action • Putting injury on the map • The road ahead • Everyone has an injury story
injury Putting Injury & Violence prevention on the public health map
Healthy Carolinians is and will be an increasing critical partner in preventing injury and violence in North Carolina
¿Preguntas? Scott Proescholdbell, MPH Injury and Violence Prevention Branch Chronic Disease and Injury Section NC Division of Public Health 919-707-5442 www.injuryfreenc.ncdhhs.gov