Injury Prevention in Indian Country
Bridget Canniff
Project Director
Injury Prevention Program
Northwest Portland Area
Indian Health Board
Indian Leadership for Indian Health
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,
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
 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
Buckle up those you love
and for those who love you
Motor Vehicle Safety
Seat Belts and Child Safety Seats
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
• Promote restraint use for all ages
• Discourage aggressive / distracted driving
• Enforcement of laws
• Provide community education
• Change societal attitudes
“We Don’t Buckle Up!”
“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
Help the body slow down
Contact the strongest
parts of the body
Spread forces over a wide
area of the body
Protects the brain, spinal
cord, & for kids, abdomen
Keep adults and children
in the vehicle
4 Steps for Kids
1. Rear-facing
2. Forward-facing
3. Booster seats
4. Adult seat belts
Step 1
Infant Seats
At minimum:
Keep infants
until 1 year and
20 lbs
until 2 years
Steps 1 & 2
Rear-Facing /
Reclined for rearfacing and upright
for forward-facing
Step 2
Child Seats
 Follow
for specific seat
Step 3
Booster Seats
■ Booster seats are for
children from 40 to
High back
80/100 pounds
■ Lap/shoulder belt
■ Head restraint
■ Use shoulder belt
Belt-positioning backless booster
Step 4
Seat Belts
■ 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+
■ All children under the age of
13 should still sit in the back
Incorrect Restraint Use
Children using adult seat belt face
3.5 times greater risk for serious
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
• Community Education
• Enact and enforcement of
restraint laws
• Educating Head Starts, daycares,
schools and health care
• Encouraging Tribal leaders and
elders to spread the message
• Car seat distribution programs and
• Certified Child Passenger Safety
(CPS) technicians
• Working with car manufacturers and
car seat designers on compatibility
Motor Vehicle Safety Resources
• NPAIHB IP Program
Luella Azule, IP Coordinator & CPS Technician
[email protected] 503-416-3263
• National Highway Traffic Safety Administration
• Washington Safety Restraint Coalition
• Washington State Booster Seat Coalition
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
Proven Interventions
Comprehensive check-ups
Medication management
Vision care
Make home safe
Regular exercise for
balance & strength
Elder Falls Resources
• NPAIHB IP Website
• Fall Prevention Center of Excellence (CA)
• CDC National Center for Injury Prevention and
Poisoning Prevention
Poisoning Prevention
• Household chemicals
and poisons
• Lead
• Carbon monoxide
• Medications and
• 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
• Take Back Your Meds (WA)
• CDC Healthy Homes – Poisoning Prevention
Community Injury Prevention
Priorities & Partnerships
• What injury
prevention efforts
are priorities for
YOUR tribal
• Who is involved, or
could be involved?
• Needs? Interests?
Goals? Resources?
Public Health Approach
Define the
Implement &
Evaluate Programs
Risk Factors
-Who, What?
Find what Prevents
the Problem
-What Works?
Adapted from National Center for Injury Prevention and Control, CDC
Assess the Need in Your
• Who is being injured? Where? Circumstances?
• How? How many? How serious?
• What time period? Increasing or decreasing in
• Which of these injuries is most significant in
terms of:
 personal impact
 economic costs
 social consequences
Assess the Need in Your
• 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
• Community strengths (cultural, attitudes, beliefs,
behaviors) to reduce injuries?
• What’s needed to evaluate an intervention?
Injury Prevention Resources
• NPAIHB Injury Prevention Program
• CDC National Center for Injury
Prevention and Control (NCIPC)
Injury Prevention Contacts
Luella Azule (Yakama Nation/Umatilla)
Injury Prevention Coordinator
[email protected]
Bridget Canniff
Project Director, Injury Prevention Program
[email protected]
Thank you!

2013 Risky Business_Injury Prevention Presentation