Chap 17: Injuries as a Community

Health Problem

Anita Sego

Spring, 2005
 Chap 17: Injuries

Chapter Objectives
• Describe the importance of injuries as a
community health problem.
• Explain why the terms accidents and safety
have been replaced by the currently more
acceptable terms unintentional injuries, injury
prevention, and injury control when dealing with
such occurrences.
• Briefly explain the difference between
intentional injuries and provide examples of
each.
 Chap 17: Injuries

Chapter Objectives
• List the four elements usually included in the
definition of the term unintentional injury.
• Summarize the epidemiology of unintentional
injuries.
• List strategies for the prevention and control of
unintentional injuries.
• Explain how education, regulation, automatic
protection, and litigation can reduce the number
and seriousness of unintentional injuries
 Chap 17: Injuries

Chapter Objectives
• Define the term intentional injuries and
provide examples of behavior that
results in intentional injuries.
• Describe the scope of intentional injuries
as a community health problem in the
United States.
• List some contributing factors to
domestic violence and some strategies
for reducing it.
 Chap 17: Injuries

Chapter Objectives
• List some of the contributing factors to
the increase in violence related to youth
gangs and explain what communities
can do to reduce this level of violence.
• Discuss intervention approaches in
preventing or controlling intentional
injuries.
 Chap 17: Injuries

Definitions
• Injury
– acute exposure to physical agents interacting with the
body in amounts or at rates that exceed the threshold
of human tolerance.
• Unintentional injuries
– are those judged to have occurred without anyone
intending harm to be done
• Intentional injuries
– have been purposely inflicted whether by oneself or
another
 Chap 17: Injuries

Characteristics of
Unintentional Injuries
1. Unplanned events
2. Preceded by an unsafe act or condition
3. Accompanied by economic loss
4. Interrupt the efficient completion of
tasks.
 Chap 17: Injuries

Cost of Injuries to Society

• 5.8 million death per year worldwide
• 150,000 deaths per year in the US
– 94,331 unintentional
– 30,575 suicides
– 17,893 homicides
• 54 million injuries
• 21 million disabling injuries
• $469 billion/year
 Chap 17: Injuries

Injury Deaths U.S. (1998)

Homicide Undetermined
12% 3%

Suicide
21% Unintentional
64%
 Chap 17: Injuries

Causes of Years of Potential Life Lost (per

100,000 pop.)

2500

2000

1500
per 100,000 pop

1000

500

0
Injury Cancer Heart HIV/ AIDS
Disease
 Chap 17: Injuries

Cost Estimate ($billions 1996 dollars)

300

250

200

150

100

50

0
Injury Cancer Heart Disease
 Chap 17: Injuries

Number of Deaths (1996)

800000
700000
600000
500000
400000
300000
200000
100000
0
Injury Cancer H eart HIV/ AIDS
Disease
 Chap 17: Injuries

Unintentional Injuries
• Motor vehicle crashes
– #1 cause of unintentional injury deaths
– 41,611 fatalities in 1999
– 3.3 million non-fatal injuries in 1999
• Other types
– falls 17,100 deaths - suffocation
– poisonings 10,500 deaths - fires & burns
– drowning 4,000 - discharge of
firearms
 Chap 17: Injuries

Epidemiology of Unintentional
Injuries
• Person
• Age
– leading cause of death in the 1-44 year age
group
• Gender
– males are twice as likely as females
• Race
– leading cause of death for all racial & ethnic
groups excepts Blacks
 Chap 17: Injuries

Epidemiology of Unintentional
Injuries
• Place
• Home
– more unintentional injuries occur in the home than in
any other place
• Highway
– ranks 2nd for non-fatal injuries; ranks 1st for
unintentional injury deaths
• Recreation/Sports Area
– Third mostly likely place to sustain injury
• Workplace
– 4th highest rate of unintentional injuries
 Chap 17: Injuries

Unintentional Deaths Location

(US 1999)

work/
Public Work motor-
vehicle

Motor- H ome
vehicle
 Chap 17: Injuries

Epidemiology of Unintentional
Injuries
• Time
• Motor Vehicle Crashes
– highest rate in January and December
– alcohol involved in half of fatal crashes
• Drowning
– more occur in the summer months
– alcohol is involved in nearly half
• Fires
– more occur in the winter months
 Chap 17: Injuries

Prevention through
Epidemiology
• Injury Prevention & Control Contributors
– Hugh De Haven
– John E. Gordon
– William Haddon, Jr.
• Public Health Model
– similar to communicable disease model -
except agent is “energy” in this model
 Chap 17: Injuries

Energy

Host Environment

Public Health Model for Unintentional Injuries

 Chap 17: Injuries

Energy

Control tactics based upon

interrupting transmission
of damaging energy to host.

Host Environment

Public Health Model for Unintentional Injuries

 A.
A. Prevent
Prevent accumulation
accumulation ofof energy
energy
B.
B. Prevent
Prevent the
Chap 17:
the inappropriate
Injuries
inappropriate release
release of
of
energy
energy
C.
C. Place
Place aa barrier
barrier between
between host
host && agent
agent
D.
D. Completely
Completely separate
separate the
the host
host from
from the
the
source
source of
of energy
energy

Energy

Control tactics based upon

interrupting transmission
of damaging energy to host.

Host Environment

Public Health Model for Unintentional Injuries

 Chap 17: Injuries
Community Approach to
Prevention of Unintentional
Injuries
• Education
• Regulations
• Emergency Response System
• Automatic Protection
• Litigation
 Chap 17: Injuries

Injuries
• Intentional
– approximately 50,000 people die each year
– approximately 2.2 million receive nonfatal injuries as
a result of interpersonal violence
• Types
– Assaults
– Family Violence
– Rape
– Robbery
– Suicide
– Homicide
 Chap 17: Injuries

Epidemiology of Intentional
Injuries
• Rates of homicide, assault, & rape
– homicide rate 9.8 per 100,000
– declining rates
– risk factors
• Suicide & attempted suicide
– nearly 30,000 suicides are reported each year
– rates among the young have tripled since 1950
• Firearm injuries
– 2nd leading cause of injury death
– 60% of homicide & 55% of suicides involved a firearm
 Chap 17: Injuries

Violence in our Society

• Individuals & Violence
– lack communication & problem solving skills
– firearms are easy to obtain & deadly
• Family Violence & Abuse
– 1 in 6 homicides is the result of family violence
– Child Maltreatment
• Child abuse
• Child neglect
• Intimate Partner Violence
• Model for abuse
• Gangs & Violence
 Chap 17: Injuries

Ep lent
de
iso
V io
Crisis state
Stress period
Honeymoon

Ca
ml
ne
ss
 Chap 17: Injuries

Approaches to Prevention
• Education
– Safe School/Healthy Student Initiative
• Employment & Recreation Opportunities
• Regulation & Enforcement
– Brady Bill
– Electronic detection of weapons
– Other types of regulation
• Counseling & Treatment
– represent secondary & tertiary prevention
 Chap 17: Injuries

Chapter 17

Injuries As A
Community Health Problem