Injury Prevention in Indian Country
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Injury Prevention in Indian Country. Bridget Canniff Project Director Tribal Epidemiology Center Consortium Northwest Portland Area Indian Health Board. What are Unintentional Injuries?. Damage or harm caused to the body by an outside agent or force

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Injury Prevention in Indian Country

Bridget Canniff

Project Director

Tribal Epidemiology Center Consortium

Northwest Portland Area Indian Health Board


What are unintentional injuries
What are Unintentional Injuries?

  • Damage or harm caused to the body by an outside agent or force

  • Does not include injuries related to violence (assault, abuse, homicide, suicide)

What is Injury Prevention?

  • Efforts to prevent or reduce the severity of bodily injuries before they occur

  • Programs that advance the health of the population by preventing injuries and improving quality of life


Key unintentional injury topics
Key Unintentional Injury Topics

  • Motor Vehicle Safety: Seat Belts

  • Motor Vehicle Safety: Child Safety Seats

  • Elder Safety & Falls Prevention

  • Bike Safety & Helmet Use

  • Home Safety & Fire Prevention



Motor vehicle safety
Motor Vehicle Safety

  • On average, 2 AI/ANs are killed every day in crashes in the US 1

1 Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. (2005) [cited Feb 18 2009].  Available from URL: www.cdc.gov/ncipc/wisqars


Motor vehicle safety1
Motor Vehicle Safety

  • Make sure vehicles are safe and in working order

  • Use car seats for children

  • Ensure drivers and passengers wear seat belts

  • Enforce speed limits and discourage aggressive driving

  • Enforce laws against impaired driving


The traffic death rate for ai ans in washington is times higher than for non natives 2
The traffic death rate for AI/ANs in Washington is ____ times higher than for non-Natives.2

  • 1.7

  • 2.5

  • 3.3

  • 4.2

2 Washington Traffic Safety Commission. Tribal Traffic Safety [online]. (2010) [cited Feb 22 2010].  Available from URL: http://www.wtsc.wa.gov/programs/tribal.php


Five ways seat belts prevent injury
Five Ways Seat Belts Prevent Injury times higher than for non-Natives.

Keep people in the vehicle

Contact the strongest parts of the body

Spread forces over a wide area of the body

Help the body to slow down

Protect the brain and spinal cord


We don t buckle up
“We Don’t Buckle Up!” times higher than for non-Natives.

“We don’t get tickets out here on the Rez”

“I am only going down the street”

“I just don’t think about it”

“I let the kids get out of their belts once we are on our Rez roads”


How often do you wear your seatbelt
How often do YOU wear your seatbelt? times higher than for non-Natives.

  • Always

  • Usually

  • Sometimes

  • Occasionally

  • Never


The message for native communities buckle up for every ride
The Message for Native Communities: Buckle Up for Every Ride times higher than for non-Natives.

  • Wearing a seat belt is the easiest way to prevent injury or death

  • It only takes a few seconds to buckle up - you never know when you may be in a crash

  • Buckle up for every ride in the car, even short trips


Motor vehicle safety resources
Motor Vehicle Safety Resources times higher than for non-Natives.

  • Washington Traffic Safety Commission http://www.wtsc.wa.gov/programs/tribal.php

  • Washington Safety Restraint Coalition www.800bucklup.org/


Motor vehicle safety child safety seats

Motor Vehicle Safety: times higher than for non-Natives.Child Safety Seats


Why use child safety seats
Why use Child Safety Seats? times higher than for non-Natives.

Motor vehicle crashes are theLEADING CAUSE OF DEATH for AI/AN children between ages 1-9 (as well as AI/ANs 1-44).

… making up one-thirdof all child deaths 3

3 Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. (2005) [cited Feb 17 2009].  Available from URL: www.cdc.gov/ncipc/wisqars


Five ways child safety seats prevent injury
Five Ways Child Safety Seats Prevent Injury times higher than for non-Natives.

Keep children in the vehicle

Contact the strongest parts of the body

Spread forces over a wide area of the body

Help the body to slow down

Protect the brain, spinal cord and abdomen


4 steps for kids
4 Steps for Kids times higher than for non-Natives.

1. Rear-facing

2. Forward-facing

3. Booster seats

4. Adult seat belts



Minimum recommendations
Minimum recommendations belt?

  • Rear-facing seats: Until age 1 AND at least 20 lbs

  • Forward-facing seats: Until upper limit for specific seat, usually age 4 AND 40 lbs

  • Booster seats: Until age 8 OR 4’9” tall

  • Adult seat belts in back seat: Until age 13


Step 1 rear facing infant seats

Keep infants rear-facing until a minimum of age 1 and at least 20 pounds.

Step 1: Rear-facing Infant Seats


Step 1 2 rear facing forward facing convertibles
Step 1 & 2: Rear-Facing / Forward-Facing Convertibles least 20 pounds.

  • Rear and forward facing

  • Reclined for rear-facing and upright for forward-facing

  • Can be used for larger infants less than one year old and 20-35 pounds


Step 2 forward facing child restraints

Convertible and Forward-facing only least 20 pounds.

Child must be: One year old AND 20+ pounds

Step 2: Forward-Facing Child Restraints


Step 3 booster seats
Step 3: Booster Seats least 20 pounds.

High back booster

Belt-positioning backless booster

  • Booster seats are for children from 40 to 80 pounds

  • Lap/shoulder belt only

  • Head restraint

  • Use shoulder belt positioners


Step 4 seat belts
Step 4: Seat Belts least 20 pounds.

  • Vehicle seat belts are made for adults and older children 4’9” or taller

  • Most children reach this height at 8 years old and 80+ pounds

  • All children under the age of 13 should still sit in the back seat


Incorrect restraint use
Incorrect Restraint Use least 20 pounds.

  • Children using adult seat belt face 3.5 times greater risk for serious injury

  • Child restraints reduce risk of death by 28% compared to adult seat belt

  • 51-82% of infant car seats and 30% of booster seats are used incorrectly

    • incorrect installation

    • incompatible with child’s height, weight, or age

    • straps are too loose

      www.boosterseat.org


Tribal child safety seat laws
Tribal Child Safety Seat Laws least 20 pounds.

  • Does your tribe have a current law for on reservation?

  • Do you know what that law mandates?

  • What are your impressions of community compliance with state or tribal laws?


Possible interventions
Possible Interventions least 20 pounds.

  • Certified Child Passenger Safety (CPS) technician

  • Free or low cost child seats

  • Loaner program

  • Enact child passenger restraint law / Increased enforcement of existing laws

  • Health care providers ask about car seat use & reinforce the importance of seats

  • View crash test videos

  • Have wrecked vehicle at community events

  • Training on proper use

  • Have children design seat covers


Child safety seat resources
Child Safety Seat Resources least 20 pounds.

  • National Highway Traffic Safety Administration www.nhtsa.gov

    • Washington State Booster Seat Coalition www.boosterseat.org

  • Washington Safety Restraint Coalition www.800bucklup.org/


Elder safety and falls prevention

Elder Safety least 20 pounds.and Falls Prevention


Impact of elder falls
Impact of Elder Falls least 20 pounds.

3 Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) [online]. (1999-2007) [cited Feb 18 2009].  Available from URL:www.cdc.gov/ncipc/wisqars

In the Northwest, falls are responsible for up to 25% of unintentional injury deaths for American Indians/Alaska Natives aged 55 and over 3


Proven interventions what works
Proven Interventions: least 20 pounds.What Works

  • Comprehensive check-ups

  • Medication management

  • Vision care

  • Home safety

  • Regular exercise for balance & strength


Elder falls resources
Elder Falls Resources least 20 pounds.

  • Fall Prevention Center of Excellence (CA) www.stopfalls.org

  • CDC National Center for Injury Prevention and Control www.cdc.gov/homeandrecreationalsafety/falls


Bike safety and helmet use

Bike Safety least 20 pounds.and Helmet Use

Protecting Yourself, Your Family, and Your Community


Why wear helmets
Why Wear Helmets? least 20 pounds.

  • Native American children die from injuries twice as often as children from other races 4

  • Helmets can reduce head injuries by 85% and brain injuries by 88% 5

4National Center for Health Statistics. Centers for Disease Control and Prevention. National Vital Statistics System. 2000-2004 mortality statistics. Hyattsville (MD): National Center for Health Statistics, 2007. Accessed 3/6/08

5National SAFE KIDS Campaign (NSKC). Bicycle Injury Fact Sheet. Washington (DC): NSKC, 2004. http://www.usa.safekids.org/tier3_cd.cfm?folder_id=540&content_item_id=1010. Accessed 2/7/2008.


Bike and helmet safety resources
Bike and Helmet Safety Resources least 20 pounds.

  • National Bike Safety Coalition www.cdc.gov/HomeandRecreationalSafety/bikeinjuries.html

  • Pedestrian and Bicycle Information Center www.bicyclinginfo.org


Home safety and fire prevention

Home Safety least 20 pounds.and Fire Prevention

Protecting Yourself, Your Family, and Your Community


Keeping homes safe
Keeping Homes Safe least 20 pounds.

Escape plans

Emergency services

Smoke/CO2 detectors

Home safety for Elders

Youth programs and activities

Environmental concerns


Home and fire safety resources
Home and Fire Safety Resources least 20 pounds.

FireSafety.gov

Home Safety Council www.homesafetycouncil.org


Preventing Injuries at the Community Level least 20 pounds.

  • What injury prevention efforts are priorities for YOUR communities?

  • Who is involved, or could be involved?


Injury prevention in indian country toolkit
Injury Prevention in Indian Country Toolkit least 20 pounds.

  • Designed for those interested in starting or expanding Tribal Injury Prevention Programs

  • Full Toolkit or CD only

  • Fact sheets, presentations, brochures

  • Developed jointly by Northwest, California and Southern Plains Tribal EpiCenters


Assessing the need in your community
Assessing the Need in Your Community least 20 pounds.

  • Who is being injured?

  • How are these people being injured?

  • How many of these injuries have occurred, and over what time period? Are they increasing or decreasing in frequency?

  • Which of these injuries is most significant in terms of:

    • personal impact

    • economic costs

    • social consequences


Assessing the need in your community1
Assessing the Need in Your Community least 20 pounds.

Are local injury rates higher or lower than the national or state rate? How does it compare to other health problems?

What are community issues (cultural, attitudes, beliefs, behaviors) that could be contributing to injuries?

What is involved in decreasing injuries? Are there strategies other communities have used that have proven effective or promising?

What are community strengths (cultural, attitudes, beliefs, behaviors) that could help reduce injuries?


General injury prevention resources
General Injury Prevention Resources least 20 pounds.

  • Indian Health Service Portland Area Injury Prevention www.ihs.gov/MedicalPrograms/portlandinjury

  • CDC National Center for Injury Prevention and Control (NCIPC) www.cdc.gov/injury


This presentation is a collaboration between the Tribal Epidemiology Center Consortium (with materials coming from the consortium’s Injury Prevention in Indian Country toolkit) and the Native CARS Study.

CONTACTS:

Bridget Canniff

Tribal EpiCenter Consortium

503-228-4185 x302

[email protected]

Tam Lutz, Native CARS

503-228-4185 x271

[email protected]

This publication was supported by Award Number U50 MN024133 from the Centers for Disease Control and Prevention through a Cooperative Agreement with the Tribal Epidemiology Center Consortium. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC.


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