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Injury Prevention in Indian Country. Bridget Canniff Project Director Injury Prevention Program. What is Injury?. Damage or harm caused to the body by an outside agent or force Unintentional Injury (aka “Accidents”)

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injury prevention in indian country

Injury Prevention in Indian Country

Bridget Canniff

Project Director

Injury Prevention Program

what is injury
What is Injury?

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

Unintentional Injury (aka “Accidents”)

  • unplanned/unexpected events (most falls, motor vehicle crashes, drowning, burns, etc.)

Intentional Injury

  • self-inflicted violence (suicide/attempt)
  • assault, domestic violence, homicide
injuries are not accidents
Injuries are NOT accidents!
  • They are NOT random, unavoidable events
  • They occur in predictable patterns
  • They are associated with risk factors
  • Most are preventable
what is injury prevention
What is Injury Prevention?
  • Efforts to prevent or reduce the severity of injuries before they occur
  • Programs which 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, Child Safety Seats, Impaired or Distracted Driving Prevention
  • Elder Falls Prevention
  • Poisoning Prevention
  • Home Safety & Fire Prevention
  • Bike Safety & Helmet Use
  • Water Safety & Drowning Prevention
  • Firearms Safety
motor vehicle safety1
Motor Vehicle Safety
  • What things can help improve safety on the road?
  • What can we do to prevent crashes and reduce injury from crashes?
motor vehicle safety2
Motor Vehicle Safety
  • Ensure vehicles are safe and in working order
  • Promote restraint use for all ages
  • Discourage aggressive / distracted driving
  • Enforcement of laws
  • Provide community education
  • Change societal attitudes
we don t buckle up
“We Don’t Buckle Up!”


“We don’t get tickets on the Rez.”

“I am only going down the street.”

“I just don’t think about it.”

“He’ll stop crying if I hold him in my lap.”

“She thinks she’s too old.”

5 ways seat belts and child safety seats prevent injury
5 Ways Seat Belts and Child Safety Seats Prevent Injury
  • Help the body slow down
  • Contact the strongest parts of the body
  • Spread forces over a wide area of the body
  • Protects the brain, spinal cord, & for kids, abdomen
  • Keep adults and children in the vehicle
4 steps for kids
4 Steps for Kids



Booster seats

Adult seat belts

step 1
At minimum: Keep infants rear-facing until 1 year and 20 lbs

Recommended: until 2 years

Step 1

Rear-Facing Infant Seats

steps 1 2
Steps 1 & 2

Rear-Facing /

Forward-Facing Convertibles

  • Reclined for rear-facing and upright for forward-facing
step 2
Step 2

Forward-Facing Child Seats

  • Follow recommendation for specific seat
step 3
Step 3
  • Booster seats are for children from 40 to 80/100 pounds
  • Lap/shoulder belt only
  • Head restraint
  • Use shoulder belt positioners

Booster Seats

High back booster

Belt-positioning backless booster

step 4
Step 4
  • 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

Seat Belts

incorrect restraint use
Incorrect Restraint Use
  • Children using adult seat belt face 3.5 times greater risk for serious injury
  • 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
seat belts child safety seats
Seat Belts & Child Safety Seats
  • Does your tribe have current laws for on reservation belt/safety seat use, or follow state law?
  • What do the laws mandate?
  • What are your impressions of community compliance with state or tribal laws?
the message for native communities
The Message for Native Communities
  • Wearing a seat belt and keeping children in safety seats is the easiest way to prevent injury or death
  • It only takes a few seconds – you never know when you may be in a crash
  • Buckle up for every ride, even short trips
  • Community Education
  • Enact and enforcement of restraint laws
  • Educating Head Starts, daycares, schools and health care providers
  • Encouraging Tribal leaders and elders to spread the message
  • Car seat distribution programs and checks
  • Certified Child Passenger Safety (CPS) technicians
  • Working with car manufacturers and car seat designers on compatibility
motor vehicle safety resources
Motor Vehicle Safety Resources
  • NPAIHB IP Program

Luella Azule, IP Coordinator & CPS Technician 503-416-3263

  • National Highway Traffic Safety Administration

  • Washington Safety Restraint Coalition

  • Washington State Booster Seat Coalition

impact of elder falls
Impact of Elder Falls
  • In the Northwest, falls are responsible for up to 25% of unintentional injury deaths for American Indians/Alaska Natives aged 55 and over

Source: 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

proven interventions
Proven Interventions
  • Comprehensive check-ups
  • Medication management
  • Vision care
  • Make home safe
  • Regular exercise for balance & strength
elder falls resources
Elder Falls Resources
  • NPAIHB IP Website injury_prevention_program

  • Fall Prevention Center of Excellence (CA)
  • CDC National Center for Injury Prevention and Control
poisoning prevention1
Poisoning Prevention
  • Household chemicals and poisons
  • Lead
  • Carbon monoxide
  • Medications and drugs
  • Keep cleaning products and chemicals out of children’s reach
  • Test for lead paint
  • Install carbon monoxide detectors
  • Lock up medications
poisoning resources
Poisoning Resources
  • Lock Your Meds

  • Take Back Your Meds (WA)

  • CDC Healthy Homes – Poisoning Prevention


priorities partnerships
Priorities & Partnerships
  • What injury prevention efforts are priorities for YOUR tribal communities?
  • Who is involved, or could be involved?
  • Needs? Interests? Goals? Resources?
public health approach
Public Health Approach

Define the



Implement &

Evaluate Programs



Risk Factors

-Who, What?

Find what Prevents

the Problem

-What Works?

Adapted from National Center for Injury Prevention and Control, CDC

assess the need in your community
Assess the Need in Your Community
  • Who is being injured? Where? Circumstances?
  • How? How many? How serious?
  • What time period? Increasing or decreasing in frequency?
  • Which of these injuries is most significant in terms of:
    • personal impact
    • economic costs
    • social consequences
assess the need in your community1
Assess the Need in Your Community
  • Local injury rates: higher/lower than national/state rates? How does it compare to other health problems?
  • Community issues (cultural, attitudes, beliefs, behaviors) contributing to injuries?
  • How to decreasing injuries? Proven/effective strategies?
  • Community strengths (cultural, attitudes, beliefs, behaviors) to reduce injuries?
  • What’s needed to evaluate an intervention?
injury prevention resources
Injury Prevention Resources
  • NPAIHB Injury Prevention Program injury_prevention_program
  • CDC National Center for Injury Prevention and Control (NCIPC)
injury prevention contacts
Injury Prevention Contacts

Luella Azule (Yakama Nation/Umatilla)

Injury Prevention Coordinator


Bridget Canniff

Project Director, Injury Prevention Program




Thank you!