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  1. Army Burden of InjuriesDefining the Problem and Prevention BG Timothy Adams AUSA, Washington Convention Center 6 OCT 2009

  2. Relative Burden of Injuries and Diseases, U.S. Army Active Duty, 2008 Source: Defense Medical Surveillance System, Armed Forces Health Surveillance Center, 2009

  3. Army Deployment Injuries and DiseasesOIF Medical Evacuations, 2003 - 20081 ICD-9-CM Code Groups 1 Total evacuations: n= 38,619 Source: USACHPPM Deployment Injury Surveillance System

  4. Five Key Public Health Questions • Is there a problem and how big is it? • What causes the problem? • What works to prevent the problem? • Who needs to know and do what? • How effective is what we have done? Five Steps of the Public Health Approach • Surveillance • Research & field investigations • Intervention trials & systematic reviews • Program and policy implementation • Public health evaluations & monitoring

  5. Leading Causes of Injury Hospitalizations U.S. Army Active Duty, 2008 Source: Defense Medical Surveillance System, Armed Forces Health Surveillance Center, 2009

  6. Leading Causes of Deployment Non-Battle InjuriesArmy OIF Medical Evacuations,2003-2008 Source: USACHPPM Deployment Injury Surveillance System

  7. USACHPPM Top Ten Injury Prevention Priorities* * Results of a prioritization process conducted by Army members of the DoD Health Affairs Military Injury Prevention Priorities Working Group, 2006

  8. Recommendations for Prevention

  9. Injury visit rates among Army trainees, 2000-2008 New PT Program Source: Defense Medical Surveillance System, Armed Forces Health Surveillance Center, 2009

  10. USACHPPM Injury Prevention Services & Products • Detection • Surveillance & surveillance analysis • Response • Field investigations • Systematic scientific reviews of science • Recommendations for policies and programs • Evaluations of policies and programs • Dissemination • Consultations & Information Requests (phone, e-mail, site visits) • Lay information products (web, magazines, news articles, talks, etc.) • Scientific information (tech reports, peer-reviewed publications, presentations, etc.) • Customers • Examples: Training & Doctrine Command, Forces Command, Medical Command, Deputy Assistant Sec’y of Army/Safety & Occupational Health, Army Combat Readiness/Safety Center, Assistant Sec’y of Defense/Health Affairs, Under Sec’y of Defense/Personnel & Readiness, Unit Commanders, other Fed Agencies

  11. Army Injury Prevention Partners and Activities • USACHPPM • Lead for injury surveillance and prevention • Key Partners and Activities • Army • Office of the Surgeon General Proponency Office for Rehabilitation & Reintegration • Musculoskeletal Action Plan (MAP) • TBI Surveillance and Prevention • Army Medical Research and Development Command • Army Combat Readiness /Safety Center • DOD • Defense Safety Oversight Council • Military Training Task Force • Deployment & Operations Task Force • Joint Military Vehicle Safety Working Group

  12. The Public Health Approach • Surveillance • Research and field investigations • Intervention trials and systematic reviews • Program and policy implementation • Public health evaluations and monitoring A problem this large & complex requires a systematic approach to prevention.

  13. Conclusions & Future Directions • Keys to Injury Program Success • Routine use of surveillance data to identify & monitor problems • Strategic planning and established priorities • Credibility and durability of science derived from peer-reviewed publications • Partnerships • Quick response capabilities • Requirements for Future Success • Disseminate injury data to MACOMs and units • for visibility • for accountability • Wide adoption of evidence-based public health approach by Army and DOD • Enhanced dissemination and training for Injury Prevention within Army and DOD • Establish DOD, Army, Installation and large unit committees to set priorities, share information, and monitor success • Enforcement of Safety and Injury Prevention standards

  14. Contact information and resources Contact Information: USACHPPM Injury Prevention Homepage http://chppm-www.apgea.army.mil/DEDS-Injury/ (410) 436-3534 DSN 584-3534 Resources: Physical Training Injury Prevention Toolbox http://chppm-www.apgea.army.mil/ptipt/default.aspx Injury Prevention Through Leadership Course Available through the PT Injury Prevention Toolbox homepage (above) US Army Combat Readiness/Safety Center Knowledge Publication https://safety.army.mil/Knowledge_Online/Default.aspx?alias=safety.army.mil/Knowledge_Online/October2009