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90110 pp tx_ch15


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  • 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?