Chap 17: Injuries as a Community Health Problem

Instructor’s Name

Semester, 200_

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• Explain why the terms accidents and safety have been replaced by the currently more acceptable terms unintentional injuries, injury prevention, and injury control when dealing with such occurrences.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– 94331 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)

Undetermined3%

Homicide12%

Suicide21% Unintentional

64%

Chap 17: Injuries

Causes of Years of Potential

Life Lost (per 100,000 pop.)

0

500

1000

1500

2000

2500

Injury Cancer HeartDisease

HIV/AIDS

per 100,000 pop

Chap 17: Injuries

Cost Estimate ($billions 1996 dollars)

0

50

100

150

200

250

300

Injury Cancer Heart Disease

Chap 17: Injuries

Number of Deaths (1996)

0

100000

200000

300000

400000

500000

600000

700000

800000

Injury Cancer HeartDisease

HIV/ AIDS

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: InjuriesEpidemiology 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: InjuriesEpidemiology 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

HomeMotor-vehicle

Public work/ motor-vehicle

Chap 17: InjuriesEpidemiology 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

EnergyEnergy

HostHost EnvironmentEnvironment

Public Health Model for Unintentional Public Health Model for Unintentional InjuriesInjuries

Public Health Model for Unintentional Public Health Model for Unintentional InjuriesInjuries

Chap 17: Injuries

EnergyEnergy

HostHost EnvironmentEnvironment

Public Health Model for Unintentional Injuries

Public Health Model for Unintentional Injuries

Control tactics based upon interrupting transmission

of damaging energy to host.

Chap 17: Injuries

EnergyEnergy

HostHost EnvironmentEnvironment

Public Health Model for Unintentional InjuriesPublic Health Model for Unintentional Injuries

Control tactics based upon interrupting transmission

of damaging energy to host.

A. Prevent accumulation of energyB. Prevent the inappropriate release of

energyC. Place a barrier between host & agentD. Completely separate the host from the

source of energy

A. Prevent accumulation of energyB. Prevent the inappropriate release of

energyC. Place a barrier between host & agentD. Completely separate the host from the

source of energy

Chap 17: InjuriesCommunity 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

Stress period

Vio

lent

Epis

ode

Crisis state

HoneymoonCalm

ness

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 17Chapter 17 17

Injuries As AInjuries As A

Community Health Community Health ProblemProblem