Anita Sego Spring, 2005

1. Anita Sego Spring, 2005

2. Chapter Objectives • Describe the importance of injuries as a community 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 • Explain why the terms accidents and safety have been replaced by the currently more acceptable terms unintentional injuries, injury prevention, and injury control when dealing with such occurrences.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 injuries and provide examples of each.

3. Chapter Objectives • List the four elements usually included in the definition of the term unintentional injury. • Summarize the epidemiology of unintentional injuries. • 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

4. Chapter Objectives • Define the term intentional injuries and provide examples of behavior that results in intentional injuries. • Describe the scope of intentional injuries as a community health problem in the United States. • List some contributing factors to domestic violence and some strategies for reducing it.

5. Chapter Objectives • List some of the contributing factors to the increase in violence related to youth gangs and explain what communities can do to reduce this level of violence. • Discuss intervention approaches in preventing or controlling intentional injuries.

6. Definitions • Injury • acute exposure to physical agents interacting with the body in amounts or at rates that exceed the threshold of human tolerance. • Unintentional injuries • are those judged to have occurred without anyone intending harm to be done • Intentional injuries • have been purposely inflicted whether by oneself or another

7. Characteristics of Unintentional Injuries 1. Unplanned events 2. Preceded by an unsafe act or condition 3. Accompanied by economic loss 4. Interrupt the efficient completion of tasks.

8. Cost of Injuries to Society • 5.8 million death per year worldwide • 150,000 deaths per year in the US • 94,331 unintentional • 30,575 suicides • 17,893 homicides • 54 million injuries • 21 million disabling injuries • $469 billion/year

9. Injury Deaths U.S. (1998)

10. Causes of Years of Potential Life Lost(per 100,000 pop.)

11. Cost Estimate ($billions 1996 dollars)

12. Number of Deaths (1996)

13. Unintentional Injuries • Motor vehicle crashes • #1 cause of unintentional injury deaths • 41,611 fatalities in 1999 • 3.3 million non-fatal injuries in 1999 • Other types • falls 17,100 deaths - suffocation • poisonings 10,500 deaths - fires & burns • drowning 4,000 - discharge of firearms

14. Epidemiology of Unintentional Injuries • Person • Age • leading cause of death in the 1-44 year age group • Gender • males are twice as likely as females • Race • leading cause of death for all racial & ethnic groups excepts Blacks

15. Epidemiology of Unintentional Injuries • Place • Home • more unintentional injuries occur in the home than in any other place • Highway • ranks 2nd for non-fatal injuries; ranks 1st for unintentional injury deaths • Recreation/Sports Area • Third mostly likely place to sustain injury • Workplace • 4th highest rate of unintentional injuries

16. Unintentional Deaths Location (US 1999)

17. Epidemiology of Unintentional Injuries • Time • Motor Vehicle Crashes • highest rate in January and December • alcohol involved in half of fatal crashes • Drowning • more occur in the summer months • alcohol is involved in nearly half • Fires • more occur in the winter months

18. Prevention through Epidemiology • Injury Prevention & Control Contributors • Hugh De Haven • John E. Gordon • William Haddon, Jr. • Public Health Model • similar to communicable disease model - except agent is “energy” in this model

19. Energy Host Environment Public Health Model for Unintentional Injuries

20. Energy Control tactics based upon interrupting transmission of damaging energy to host. Host Environment Public Health Model for Unintentional Injuries

21. A. Prevent accumulation of energy B. Prevent the inappropriate release of energy C. Place a barrier between host & agent D. Completely separate the host from the source of energy Energy Control tacticsbased upon interrupting transmission of damaging energy to host. Host Environment Public Health Model for Unintentional Injuries

22. Community Approach to Prevention of Unintentional Injuries • Education • Regulations • Emergency Response System • Automatic Protection • Litigation

23. Injuries • Intentional • approximately 50,000 people die each year • approximately 2.2 million receive nonfatal injuries as a result of interpersonal violence • Types • Assaults • Family Violence • Rape • Robbery • Suicide • Homicide

24. Epidemiology of Intentional Injuries • Rates of homicide, assault, & rape • homicide rate 9.8 per 100,000 • declining rates • risk factors • Suicide & attempted suicide • nearly 30,000 suicides are reported each year • rates among the young have tripled since 1950 • Firearm injuries • 2nd leading cause of injury death • 60% of homicide & 55% of suicides involved a firearm

25. Violence in our Society • Individuals & Violence • lack communication & problem solving skills • firearms are easy to obtain & deadly • Family Violence & Abuse • 1 in 6 homicides is the result of family violence • Child Maltreatment • Child abuse • Child neglect • Intimate Partner Violence • Model for abuse • Gangs & Violence

26. Violent Episode Crisis state Stress period Honeymoon Calmness

27. Approaches to Prevention • Education • Safe School/Healthy Student Initiative • Employment & Recreation Opportunities • Regulation & Enforcement • Brady Bill • Electronic detection of weapons • Other types of regulation • Counseling & Treatment • represent secondary & tertiary prevention

28. Chapter 17 Injuries As A Community Health Problem