Ch15 outline
- 1. Injuries as a Community Health Problem Chapter 15
- 2. Introduction • Injury • Unintentional injuries • Intentional injuries • Injury prevention/control • Unsafe act • Unsafe conditions/hazards
- 3. Cost of Injuries to Society • Fatal injuries • Fifth leading cause of death in U.S. • Disabling injuries • Great human burden attributed to injuries • Significant economic costs • Greatly contribute to premature death
- 4. Injury Deaths, United States, 2007
- 5. Burden of Injury, United States, 2007
- 6. Unintentional Injuries • The cause of nearly two-thirds of all injury- related deaths in the U.S. • A major community health problem • Motor vehicle crashes • Poisoning • Falls • Other unintentional injuries
- 7. Motor Vehicle Crashes • Leading type of unintentional injury death • Leading cause of nonfatal unintentional injury • Majority of those killed are • Drivers • Passengers • Motorcycle riders • Pedestrians • Pedalcyclists
- 8. Poisonings • Second leading cause of unintentional injury death • Unintentional ingestion of fatal doses of medicines and drugs • Consumption of toxic foods • Exposure to toxic substances in the workplace or elsewhere • Most occur in the home
- 9. Falls • Third leading cause of unintentional injury death • Leading cause of injury-related ED visits • Most occur in the home • Disproportionately affect elders
- 10. Epidemiology of Unintentional Injuries • Account for large number of early deaths in U.S. • Incapacitation significant problem • High economic impact
- 11. Person • Age • Leading cause of death in children and teenagers • Falls leading cause of unintentional injury death for elders • Gender • Males more likely to be involved in fatal unintentional injuries • Minority status
- 12. Injury-Related Visits to E.D.s by Age and Sex, 2006
- 13. Place • Home • More occur in the home than anyplace else • Highway • 2nd leading place for injuries and injury death • Recreation/sports area • Workplace
- 14. Injuries by Place of Occurrence, 2008
- 15. Time • Seasonal variations in various causes of unintentional injuries • Days of week • Time of day
- 16. Alcohol Impairment for Drivers Killed
- 17. Alcohol and Other Drugs as Risk Factors • Alcohol may be most important factor contributing to injuries • Involved in high amount of motor vehicle crashes • Related to speeding, seat belt use, and other behaviors
- 18. Prevention through Epidemiology • Early contributors for injury prevention and control • John Gordon • William Haddon, Jr. • Model for unintentional injuries - triangle • Environment, host, and energy producing agent
- 19. A Model for Unintentional Injuries
- 20. Prevention and Control Tactics • Prevent accumulation of energy producing agent • Reducing speed limits, lowering settings on hot water heaters • Prevent inappropriate release of excess energy • Flame-retardant fabric, nonslip surfaces • Placing barrier between host and agent • Sunscreen, non-heat handles on cookware
- 21. Community Approaches to Prevention • Education – process of changing people’s health-directed behavior • Regulation – enacting and enforcing laws to control conduct • Automatic protection – modifying products or environments to reduce risk • Litigation – seeking justice for injury through courts
- 22. Intentional Injuries • Outcome of self-directed or interpersonal violence • Assaults, rapes, suicides, homicides • Can be perpetrated against family members, community members, or complete strangers
- 23. Epidemiology of Intentional Injuries • Interpersonal violence disproportionately affects those frustrated, hopeless, jobless, living in poverty, with low-self esteem • More acts committed by males • Firearms increasingly involved • Alcohol and drug use contributes • Perpetrators more likely to have been abused or neglected as children or exposed to violence
- 24. Homicide, Assault, Rape, and Property Crimes • Homicide victimization rate for blacks significantly higher than whites • Most homicides committed with firearms • Lower income associated with higher rate of being a victim of violence • Except for rape and sexual assault, all violent crime victimization rate higher for males • Less than half of all violent crimes committed are reported to police
- 25. Suicide and Attempted Suicide • Suicide rate for men four times that for women • Suicide rate for young people and elderly declined in recent years after significant increase from 1950-1995 • Older men eight times more likely to commit suicide than senior women
- 26. Firearm Injuries and Injury Deaths • Intentional and unintentional acts, firearms third leading cause of injury death • Highest risk for homicide and suicide involving firearms are teenage boys and young men • Guns on college campuses • Absence of detailed federally supported reporting system
- 27. Firearm-Related Injury vs. All Causes
- 28. Violence in Our Society and Resources for Prevention • Individuals and Violence • Family Violence and Abuse • Child maltreatment • Child abuse • Child neglect • Prevention of child maltreatment • Elder maltreatment • Intimate partner violence • Prevention of intimate partner violence
- 29. Violence in Schools • Victimization rates have remained steady in recent years • Fighting and weapon carrying • Zero tolerance policies • Bullying and being bullied • Safe Schools/Healthy Students Initiative • Youth violence after school
- 30. Violence in Our Communities • Youth gang violence • Costs to the community • Community response • State response • Federal response
- 31. Discussion Questions • What levels of prevention can be most effective in reducing violence in communities? • How can unintentional injury rates continue to decline in the coming decades?