Northwest Portland Area Indian Health Board

Indian Leadership for Indian Health

Injury Prevention in Indian Country

Bridget CanniffProject Director

Injury Prevention Program

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!

They are NOT random, unavoidable events

They occur in predictable patterns

They are associated with risk factors

Most are preventable

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

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 Safety

Seat Belts and Child Safety Seats

Buckle up those you love and for those who love you

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 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!”

WHY?“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

1. Help the body slow down

2. Contact the strongest parts of the body

3. Spread forces over a wide area of the body

4. Protects the brain, spinal cord, & for kids, abdomen

5. Keep adults and children in the vehicle

4 Steps for Kids

1. Rear-facing 2. Forward-facing3. Booster seats4. Adult seat belts

Step 1

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

■ Recommended: until 2 years

Rear-Facing Infant Seats

Steps 1 & 2

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

Rear-Facing / Forward-Facing Convertibles

Step 2

Forward-Facing

Child Seats Follow

recommendation for specific seat

Step 3

■ Booster seats are for children from 40 to 80/100 pounds

■ Lap/shoulder belt only

■ Head restraint■ Use shoulder belt

positioners

High back booster

Belt-positioning backless booster

Booster Seats

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

• 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

• 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

■ 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

Interventions

• 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

Interventions

• Car seat distribution programs and checks

• Certified Child Passenger Safety (CPS) technicians

• Working with car manufacturers and car seat designers on compatibility

• NPAIHB IP Program Luella Azule, IP Coordinator & CPS Technician lazule@npaihb.org 503-416-3263

• National Highway Traffic Safety Administrationwww.nhtsa.gov

• Washington Safety Restraint Coalition www.800bucklup.org

• Washington State Booster Seat Coalitionwww.boosterseat.org

Motor Vehicle Safety Resources

Elder Safety and Falls Prevention

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 URL: www.cdc.gov/ncipc/wisqars

• Comprehensive check-ups

• Medication management

• Vision care• Make home safe• Regular exercise for

balance & strength

Proven Interventions

Elder Falls Resources

• NPAIHB IP Websitewww.npaihb.org/epicenter/project/ injury_prevention_program

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

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

Poisoning Prevention

• Household chemicals and poisons

• Lead• Carbon monoxide• Medications and

drugs

Poisoning Prevention

Interventions

• Keep cleaning products and chemicals out of children’s reach

• Test for lead paint• Install carbon

monoxide detectors• Lock up medications

Poisoning Resources

• Lock Your Meds www.lockyourmeds.org• Take Back Your Meds (WA) www.takebackyourmeds.org• CDC Healthy Homes – Poisoning Prevention www.cdc.gov/healthyhomes/bytopic/ poisoning.html

Community Injury Prevention

• What injury

prevention efforts are priorities for YOUR tribal communities?

• Who is involved, or could be involved?

• Needs? Interests? Goals? Resources?

Priorities & Partnerships

Adapted from National Center for Injury Prevention and Control, CDC

Define the Problem

-Surveillance

Identify Risk Factors-Who, What?

Find what Preventsthe Problem

-What Works?

Implement & Evaluate Programs

-Prevention

Public Health Approach

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 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

• NPAIHB Injury Prevention Program www.npaihb.org/epicenter/project/ injury_prevention_program

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

Injury Prevention Contacts

Luella Azule (Yakama Nation/Umatilla)Injury Prevention Coordinator

503-416-3263lazule@npaihb.org

Bridget CanniffProject Director, Injury Prevention Program

503-416-3302bcanniff@npaihb.org

Questions?

Thank you!