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safety have been replaced by the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
• $469 billion /year
Chap 17: Injuries
Injury Deaths U.S. (1998)
Homicide
12%
Suicide
21%
Undetermined
3%
Unintentional
64%
Chap 17: Injuries
Causes of Years of Potential Life Lost
(per 100,000 pop.)
2500
per 100,000 pop
2000
1500
1000
500
0
Injury
Cancer
Heart
Disease
HIV/AIDS
Chap 17: Injuries
Cost Estimate ($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
Heart
Disease
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
- poisonings 10,500 deaths
- drowning 4,000
firearms
- suffocation
- fires & burns
- discharge of
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)
Public
Motorvehicle
Work
work/
motorvehicle
Home
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. Prevent accumulation of energy
Chap 17: release
Injuriesof
B. Prevent the inappropriate
energy
C. Place a barrier between host & agent
D. Completely separate the host from the
source of energy
Control tactics based upon
interrupting transmission
of damaging energy to host.
Host
Energy
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
Crisis state
Stress period
Honeymoon
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