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Injuries as a Public Health Problem

Injuries as a Public Health Problem. Intermediate Injury Prevention Course August 23-26, 2011 Billings, MT. Session Objectives. Severity of injuries facing AI/AN communities Costs of injury / cost benefits of prevention Community benefits of injury prevention

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Injuries as a Public Health Problem

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  1. Injuries as a Public Health Problem Intermediate Injury Prevention Course August 23-26, 2011 Billings, MT

  2. Session Objectives • Severity of injuries facing AI/AN communities • Costs of injury / cost benefits of prevention • Community benefits of injury prevention • Public Health Approach to preventing injuries • Value of data in preventing injury

  3. Why Injury Prevention? • AI/AN injury rate higher than US all races • AI/AN’s ages 1-44 are greatly affected • Injuries are very costly to treat

  4. Injuries in American Indian and Alaska Native Communities

  5. 1981 - 2005, United StatesAll Injury Deaths and Rates per 100,000Am Indian/AK Native and All U.S. CDC WISQARS, 1981-2005

  6. Fatal Injury Rates Per IHS Area2007 US All Races Rate: 59.3 Portland 80.0 Billings 159.9 Aberdeen 122.4 Bemidji 77.2 WA MT ND MN OR ID WI SD ME WY MI IA NY NE IN PA NV UT CO Nashville 47.4 California 33.7 CA KS Oklahoma City 62.3 AZ NM NC OK TN SC AL Phoenix 126.8 MS Tucson 117.2 TX LA Navajo 117.5 FL AK Albuquerque 107.9 Source: National Center for Health Statistics – Vital Statistics Systems – CD WISQARS - Data includes all injury types Rates are per 100,000 service population Alaska 163.6

  7. Leading Causes of Death AI/AN – Ages 1-44, US 2007 CDC WISQAR’S

  8. Leading Causes of Unintentional Injury Death AI/AN – Ages 1-44, US 2007 CDC WISQAR’S

  9. Leading Causes of Unintentional Injury Death Billings Area AI/AN – Ages 1-44, US 2007 CDC WISQAR’S

  10. Leading Causes of Injury Death All ages AI/AN – (2007) Billings Area Rates are per 100,000 service population CDC WISQAR’S

  11. What are the costs of injury? • Physical Losses • Financial • Emotional • Treatment

  12. Financialburden of injury

  13. Buzz Group • Why is cost important? • Who would find cost interesting?

  14. National Injury Costs$224 Billion Annually • Cost involved • Medical care, rehabilitation, lost wages / productivity • Who pays • Private share 72% (or about $161 Billion) • Public share 28% (or about $63 Billion) • Federal share • $12.6 Billion in medical costs • $18.4 Billion in disability/death costs Source: CDC, National Center for Injury Prevention and Control

  15. AI/AN Injury Costs • IHS Injury Treatment Costs • Inpatient • $1507/day (Medicaid reimbursement rate for 1 day at an IHS facility) • Contract Health • $11,305/inpatient case • $570/outpatient case • One Alaska Corporation (TCC) spent $4.15 million for injury hospitalizations from ’94-’98 Sources - (1) Indian Health Focus-Injuries 1998-99 (2) Chandler B, Berger L: Financial Burden of Injury-Related Hospitalizations to an Alaska Native Health System

  16. Financialbenefits of injury prevention

  17. Interventions that $ave Money • Primary seat belt laws/Child Car Seats • Streetlights and guardrails • Bike helmets • DUI Laws • Personal Floatation Devices • Smoke detectors • Gun locks

  18. Safety equipment saves more than lives . . . • Every bike helmet (for kids 4 – 15) saves $395 in treatment costs • Every child seat saves $1,360 • Every smoke detector saves $900 References: National Public Services Research Institute / National SAFE KIDS Campaign

  19. Injury Prevention:Potential for Cost Savings Victim Treatment costs resulting from each Motor Vehicle Crash: NOT wearinga seatbelt$2,395 Wearing a seat belt $470 Source - Phipps L: Cost Comparison of Medical Treatment for Restrained vs. Unrestrained Motor vehicle crash victims at a northeast Oklahoma IHS hospital (IHS Injury Prevention Fellowship)

  20. Injury Prevention Cost Savings Projects in Indian Country • Navajo Nation – occupant restraint usage • Whiteriver, AZ – pedestrian crash reduction • White Mountain Apache – livestock control • Y-K Delta, AK – drowning prevention

  21. Community benefits from injury prevention cost savings Elective medical services more non-emergent treatments (surgeries, therapies, preventive services, other programs) Resources for additional community services housing authorities transportation programs

  22. Prevention Implement & Evaluate Programs • What Works? Find what Prevents the Problem • Who, What? Identify Risk Factors • Surveillance Define the Problem Public Health Approach Source: National Center for Injury Prevention and Control, CDC

  23. Using Data to Define Injury Problems • Data identifies patterns and trends in injury • Observation data documents behaviors • Interview and Focus Group data can be used to identify knowledge, perceptions, and attitudes about injury

  24. Collecting and Analyzing Data to Determine Injury Risk Factors • Population at risk • age, gender, specific group • Location(s) of events • inside home, road location, at work • Environmental factors • lighting, road conditions, weather • Other factors • alcohol use, use of safety devices

  25. Using Data to Select Preventive Measures • Modify the Environment • Educate the public • Enact and Enforce safety legislation 3 E's

  26. Using Data to Evaluate Programs • Help develop intervention materials • Analyze effectiveness of methods used • Use evaluation to improve prevention measures

  27. Summary • Severity of injuries facing AI/AN communities • Costs of injury / cost benefits of prevention • Community benefits of injury prevention • Public Health Approach to preventing injuries • Value of data in preventing injury

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