Injury Prevention (or the Lack of) in Indian Country

1. Injury Prevention (or the Lack of) in Indian Country Dennis Renville, M.A. IHS Tribal Steering Committee on Injury Prevention, Chairman

2. ESTABLISHED IN 1999

3. Community Cultures/Values • Local people who are leaders • Traditional values and teachings • Understanding tribal ways

4. Mission Statement of the TSC The National Injury Prevention Steering Committee for Injury Prevention enhances the capacity of tribes to address and fund injury prevention programs, and serves as an advocate and liaison with national partners;

5. raise awareness of and support for injury prevention activities in Native American Communities; Objectives of the TSC

6. enhance the ability of Tribes to address injury problems in their communities;

7. provide advice and guidance to the Injury Prevention Program of the Indian Health Service.

8. TSC Membership Tribal Members from all 12 IHS Area

9. TSC Membership • 5-year terms • AI/AN Tribal employees or AI/AN Tribal community members, not employed by IHS • At least one Injury Prevention course or 2 years of Injury Prevention work experience

10. Core Roles for Members • Work with Tribes to obtain input and provide information. Encourage Tribes to formalize Injury Prevention as a priority – and put it in the TOP 10 of Tribal Health Priorities • Work with IHS Area Specialists, e.g., during the IHS Area budget formulation process • Participate on a regional and national level via conference calls and national TSC meetings

11. Current TSC Projects • Promote funding and support for IP programs via national organizations such as NCAI and NIHB • Participate in IHS Training efforts to recruit and select students • Work with Tribal Leaders during the budget formulation process to address IP funding issues • Presented Senate IP Briefing

12. America’s Forgotten Epidemic: American Indian/ Alaskan Native Injuries!

26. IHS 2005 Budgets Causes of Death

27. Injury Types • Unintentional Injury • unplanned/unexpected injuries (falls, most MVC’s, drowning, burns, etc.) • Intentional Injury • self-inflicted violence (suicide/attempt) • homicide • non-sexual assault • rape/sexual assault • child/elder abuse

28. Injury Severity • Fatal Injury • Injury that results in death of the victim • Severe Injury • Injury that results in a hospital stay • Ambulatory Injury • Less severe injuries that are treated by a CHA and do not require a hospital visit

29. PublicHealth Approach • Prevention Implement & Evaluate Programs • What Works? Find what Prevents the Problem • Who, What? Identify Risk Factors • Surveillance Define the Problem Source: National Center for Injury Prevention and Control, CDC

30. Clinical Approach Focused on treatment Clinical setting (one-on-one care) Explores history & health conditions leading to injury in the individual Public Health Approach Focused on prevention Community setting Explores broader patterns of injury throughout a group or population The Public Health Approachto Injury Prevention

31. Define the Problem Use local injury surveillance systems to understand: • What? • Who? • Where? • When? • How? Define the Problem

32. Identify Risk Factors • At-risk populations • Location of injury • Environmental conditions • Alcohol use • Access to firearms • Rural residence Identify Risk Factors

33. Find What Prevents the Problem • Apply proven or promising interventions • Use multiple approaches (3 E’s) • Take local circumstances into account • Collaborate with communities Find what Prevents the Problem

34. Implement & Evaluate Programs • Implement programs in ways that lend to evaluation • Study methods used to see if they worked or didn’t work • Use evaluation to improve prevention measures Implement & Evaluate Programs

35. Tribal Efforts

36. Motor Vehicle Related Injury Hospitalization Rates and Percent of Safety Belt UseNavajo Nation, 1983-1991(Enforcement)

37. Alaska Area(Engineering/Environmental) • The use of floatation devices (PFD), which were initiated in 1990, has been credited with saving 16 lives in a two year period

38. Aberdeen Area (Education) • Annual Native American Life Savers Conference • UTTC developed the nation’s first undergraduate degree (Associate of Applied Science) in Injury Prevention. To date, 37 students have graduated from the program, including two online graduates.

39. Recent TSC Activities • Developed Area Injury Fact Sheets • Developed Area Injury Prevention Flyers • Resolutions from Tribal Organizations supporting Injury Prevention • Presentations to Area IHS Budget Priorities

40. Recent TSC Activities Continued • NIHB & TSC collaboration on a U.S. Senate & House briefing on Injury Prevention • Congressional letter campaign by TSC members • Congressional visits by TSC members on Capitol Hill (6/15/05) • Partnered with NCAI & NIHB to support Injury Prevention

41. Recent TSC Activities Continued • U.S. Senate and House briefing on Injury Prevention • Submitted new language for reauthorization IHCIA supporting Injury Prevention • Collaborated with IHS Area Injury Prevention Specialist • Thank you NIHB! • Thank you AATCHB!

42. IN MEMORY OF MY BROTHER AND SISTER Died, age 29 Died, age 37

43. Childhood Interrupted … "If a disease were killing our children inthe proportions that injuries are, peoplewould be outraged and demand thatthis killer be stopped.“ C. Everett Koop, MD, Former Surgeon General

44. Remember! “Injury Preventionis the Best Medicine”

45. Pe-dah-mah-yehThank you!